Bolee Bag & BolinkCaps

Switching From a Pump to the Bolee Bag to Gain Freedom

Thu, 02 Apr 2026 19:23:18 GMT

Transition away from pump dependence while maintaining tolerance and growth

Patient Background:

4-Year old male
Autism spectrum disorder, avoidant/restrictive food intake disorder and G-tube dependence due to prior aspiration and dysphagia
14 French G-tube and a prior history of vomiting with feeds, contributing to caregiver concern regarding tolerance and delivery method

Nutrition Delivery Challenges:

Received all tube feeds via a feeding pump
Pump feeding was time-intensive, restrictive for the the child’s mobility, and poorly compatible with homemade blended feeds
Caregiver expressed dissatisfaction with the child being “hooked up” to a pump, particularly in the school setting
Had no prior experience with syringe, pouch, or bag based feeding

Solution:

Bolink Small Cap used with Kate Farms Pediatric Blended Meal pouches at school - 2 per day
Bolee Bags with Bolink Large Cap used at home for homemade blended feeds

RESULTS

Patient Satisfaction

Allowed transition away from pump dependence
Bolink Small Cap enabled quick, secure pouch feeding at school
Bolee Bag and Bolink Large Cap allowed for thicker homemade blends at home

Caregiver Feedback

Meaningful improvement in family quality of life
Significant time savings
Reduced supply cleaning
Improved convenience for home and school

Clinical Report After 3-Months

Continued success with the same feeding plan
Appropriate growth and weight gain
No vomiting or feeding intolerance
Increased flexibility to support oral intake and feeding therapy goals
Sustained caregiver satisfaction

Conclusion

The integration of U Deliver Medical products enabled the patient to:

Transition away from pump dependence while maintaining excellent tolerance and growth
Meet the family’s desire to give the commercial formula at school and homemade blends at home
Improved efficiency, flexibility, and quality of life for both the patient and family while supporting ongoing feeding therapy goals

81-Year Old Female Switches from Traditional Gravity Bag to Bolee Bag & Bolink Large Cap

Tue, 20 Jan 2026 21:09:07 GMT

Swimming With a Feeding TUbe

Thu, 31 Jul 2025 20:10:09 GMT

Tips for swimming with a feeding tube

Swimming with a feeding tube can be done safely with a few precautions to ensure that both the tube and your health are protected. Here's a guide to help you:

1. Check with Your Healthcare Provider

Get approval: Always check with your doctor or healthcare provider before swimming to ensure it’s safe based on your individual medical situation.
Specific advice: Your healthcare provider may have specific recommendations based on your type of feeding tube (e.g., PEG, G-tube, or J-tube).

2. Protect the Feeding Tube Site

Cover the site: Use a waterproof dressing or bandage to cover the tube insertion site. This helps prevent water, bacteria, and dirt from entering the site and reduces the risk of infection.
Waterproof covers: There are special waterproof covers available, like Tegaderm, which can help keep the tube site dry.
Avoid submersion for long periods: Long exposure to water can sometimes cause irritation, so limit the time you're submerged, especially in pools or hot tubs.

3. Types of Water Activities

Swimming in pools: Chlorine can be harsh on feeding tube sites, so it's crucial to protect the area carefully. You may want to avoid pools with high levels of chemicals.
Swimming in natural bodies of water: Lakes, rivers, and oceans can contain bacteria, which increases the risk of infection. It's often recommended to avoid these, or to take extra care to protect your tube and clean the area afterward.
Hot tubs: These are generally not recommended because they can increase the risk of infection and irritate the tube site due to the heat.

4. Use Waterproof Feeding Tube Caps (Optional)

Some people with feeding tubes opt to use a waterproof cap for their feeding tube when swimming. This is not always necessary but can provide extra protection. These caps can prevent water from entering the tube and causing any issues.

5. After Swimming

Clean the site: After swimming, gently wash around the feeding tube site with mild soap and water. Dry it thoroughly and check for any irritation or signs of infection.
Replace the waterproof dressing: If you used a dressing or bandage, make sure to replace it afterward, especially if it got wet.

6. Hydration

Stay hydrated: Swimming can be physically demanding, so it’s important to stay hydrated.

7. Monitor for Infection or Complications

Watch for irritation: If you notice any redness, swelling, or unusual discomfort around the tube site, consult your doctor.
Signs of infection: Keep an eye out for fever, pain, or unusual discharge from the tube site, as these could indicate an infection.

Final Thoughts:

Swimming with a feeding tube is possible, but it requires extra care. The key is to ensure the tube site is protected from bacteria, dirt, and prolonged exposure to water, as well as to follow any guidelines provided by your healthcare provider.

Disclaimer: This information is intended for general guidance only and does not replace professional medical advice. Always consult your healthcare provider for instructions and recommendations tailored to your specific situation regarding feeding tube care, swimming, and related activities.

Tube Feeding Education

udelivermedicalllc@gmail.com (U Deliver Medical) — Sun, 09 Feb 2025 19:56:19 GMT

Unlocking the Power of Visual Learning: How Seeing Enhances Understanding

In a world where we're constantly bombarded with information, learning how to process and retain knowledge is more crucial than ever. One of the most effective methods for improving understanding and recall is through visual learning. Whether you realize it or not, your brain is wired to process images faster than text. Visual learning taps into this natural ability, offering a powerful way to absorb and retain information.

Visual learning is a style of learning where information is presented through visual means—images, diagrams, charts, videos, and even color-coding—rather than relying on text alone. The key idea behind visual learning is that we understand and remember information more effectively when we can see it, rather than just hear or read it. In fact, studies have shown that visual stimuli are processed 60,000 times faster by the brain than text!

Benefits of Visual Learning:

Increased Retention and Recall - Visuals help to create strong mental associations. For example, images of a concept paired with labels or symbols give your brain more to latch onto, making it easier to retrieve the information later.
Clarifies Complex Information - Visual learning can simplify complex or abstract concepts. Diagrams, infographics, and videos can break down intricate details into digestible chunks, making hard-to-understand topics more approachable.
Enhances Engagement - Studies show that people are more likely to stay engaged when information is presented visually. Colorful images, graphs, and animations keep your brain stimulated and focused, preventing boredom and disengagement.
Improves Problem-Solving - Visualizing information can help you see relationships and patterns that might be missed through text alone. This is why many people use diagrams or flowcharts to solve problems—mapping things out visually can often make the solution clearer.
Universal Communication - Pictures and diagrams often transcend language barriers. Visual learning can be especially useful in global education or in situations where language differences exist, as images often provide a shared understanding.

All of these benefits of visual learning is why we created a library of videos showing how to use the Bolee Bag and Bolink Caps. Click below to see all of the helpful videos.

Functional Formularies Keto Diet and Bolee Bag Delivery

udelivermedicalllc@gmail.com (U Deliver Medical) — Mon, 09 Sep 2024 20:29:36 GMT

Easily Delivery Pouches of Functional Formularies with the Bolee Bag

Tube feeding nutrition comes in many different containers but high quality whole foods are usually packaged in pouches. Pouches can be difficult because after the top is torn off it can be very difficult to put the contents into bolus syringes and the inconsistent nature of the whole foods nutrition makes enteral pump use frustrating.

The reusable Bolee Bag and Bolink Large Cap is the perfect solution for delivering pouch products like the Functional Formularies Keto diet.

Functional Formularies Keto diet is the first and only organic, whole foods based ketogenic feeding tube formula and meal replacement. It's a versatile 2.43:1 Keto ratio with peptide proteins for enhanced digestion and is covered by insurance (B4149, B4153 or B4161).

The reusable Bolee Bag and Bolink Large Cap are easy to use, eliminates filling 7 messy syringes at every meal and is covered by insurance if supplied by a DME (HCPCS B4036)

Puree Pouch Direct Connect

udelivermedicalllc@gmail.com (U Deliver Medical) — Thu, 01 Aug 2024 16:37:50 GMT

Adding Whole Foods into Your Tube Feeding Diet

Do you typically use cartons of nutrition for your tube feeding meals? Have you ever wanted to add whole foods into your tube feeeding diet but found the process to be overwhelming? Puree pouches are a great, easy way to add whole food to your tube feeding diet and the Bolink® Small Cap is a direct connection from the puree pouch to your feeding tube.

Puree pouches are a type of packaging for pureed foods, typically fruits and vegetables. They are commonly used as a convenient and portable option for feeding babies and young children, but can also be enjoyed by people of all ages. The puree pouches are made with a spout at the top for easy consumption, and they are usually resealable to keep the contents fresh after opening.

These pouches often contain pureed fruits or vegetables that have been cooked and blended to a smooth consistency. Some may also include additional ingredients such as grains, yogurt, or protein to provide a more balanced meal or snack option.

Puree pouches are popular because they do not require refrigeration until after they have been opened, making them convenient for on-the-go use. They also come in a variety of flavors and combinations to appeal to different tastes and dietary needs. Additionally, many puree pouches are fortified with vitamins and minerals to enhance their nutritional value.

Overall, puree pouches offer a convenient way to tube feed healthy fruits and vegetables in an easily accessible format.

Direct Connect Tube Feeding

udelivermedicalllc@gmail.com (U Deliver Medical) — Mon, 01 Jul 2024 18:02:53 GMT

Direct connect tube feeding instead of pouring into 6 syringes

Nestle HealthScience and Kate Farms have 75 products in cartons and pouches that can be directly connected to a feeding tube using the Bolink D Cap for cartons and Bolink Small Cap for pouches.

In addition to those products, there are hundreds of pureed food pouches in the grocery stores that you can use the Bolink Small Cap to connect to your feeding tube. This is a great way to introduce whole foods into your diet or use specific fruits or vegetables to help manage your GI issues.

Bolink Caps make tube feeding easy with direct connect:

Eliminate pouring one carton into 6 bolus syringes at every meal
Tube feeding meals can take place anywhere - car, plane, train, boat, park, work, school - you get the idea
Creates a closed system so spilling is virtually impossible
All Bolink Caps are covered by insurance if they are supplied by a DME

U Deliver Medical is dedicated to making tube feeding easy with the Bolee Bag , Bolink D Cap and Bolink Small Cap .

Talk to your doctor today about switching to the Bolee Bag and Bolink Caps and take control of your tube feeding!

Tube Feeding Diet and Variety

udelivermedicalllc@gmail.com (U Deliver Medical) — Sun, 02 Jun 2024 22:01:34 GMT

Everyone Need Options

“Variety is the spice of life” is a common saying that suggests life is more interesting, enjoyable, and fulfilling when it includes a wide range of experiences, activities, and changes. This phrase emphasizes the idea that monotony and routine can make life dull and uninteresting, while introducing diversity and new experiences can add excitement and richness.

This goes for tube feeding nutrition as well. Nutritional variety keeps your gut working in different ways. Different foods and liquids exercises the digestion process indifferent ways, leading to a healthier gut. You can mix in cartons of nutrition, pouches of whole food product and making blends of you own using the foods in your refrigerator (be sure to check with your health care support team before making any major dietary changes).

U Deliver Medical has the tube feeding nutrition delivery tools to support your nutrition journey.

Bolee Bag & Bolink Large Cap

The ultimate nutrition delivery tools in supporting home tube feeding nutrition variety! The Bolee Bag and Bolink Large Cap work with cartons, pouches and home blends. Just fill the Bolee Bag with the nutrition of your choice, attach the Bolink Large Cap and connect it to your feeding tube. Great for at home or on the go.

Bolee Bags can also be filled ahead of time and stored in the Freezer or refrigerator.

Bolink Small Cap

Puree pouches are a great way to get meals and snacks on the go. The Bolink Small Cap is a direct connect between the puree food pouch and your feeding tube.

Just attach the bolink Small Cap to the puree pouch and the other end to your feeding tube. No pouring into multiple syringes or a gravity bag. Great for at home or on the go.

Bolink D Cap

Cartons of nutrition from Kate Farms and Nestle HealthScience can be directly connected to your feeding tube by using the Bolink D Cap.

Attach the Bolink D Cap to the carton and then your feeding tube and you are ready for your tube feeding meal. No more pouring into multiple syringes or a gravity bag. Great for at home or on the go.

60mL Syringe Filling

udelivermedicalllc@gmail.com (U Deliver Medical) — Wed, 01 May 2024 18:21:00 GMT

Filling an ENFit Reusable Syringe Using the Bolee Bag

The Bolee® Bag and Bolink® Caps are designed to eliminate messy syringe deliveries, but sometimes a syringe is just the preferred way to go. If that is the case, U Deliver Medi cal has a way to keep the 60mL Enfit reusable syringe clean - the Bolee Bag and an ENFit transfer lid.

It’s easy to do:

Fill the Bolee Bag with nutrition
Screw on the ENFit Transfer Lid
Attach a 60mL ENFit syringe and draw up the nutrition

Watch this video for a demonstration:

The Bolee Bag transfer method eliminates dipping the syringe tip into the pouch (5 - 6 times at every meal!) and the mess that it creates. This method also keeps the ENFit tip and threads clean and dry, making feeding tube management a little bit easier.

Tube Feeding Tips & Guidelines

udelivermedicalllc@gmail.com (U Deliver Medical) — Mon, 01 Apr 2024 16:53:38 GMT

Home Tube Feeding Tips

Making home tube feeding easier involves several considerations to ensure good nutrition, safety, efficiency, and comfort. Here are some tips to help:

Organize Supplies: Keep all necessary supplies organized and easily accessible. This includes feeding tubes, Bolee Bags, Bolink Caps, syringes for flushing, nutrition, water, cleaning supplies, and any medications or supplements.
Create a Schedule: Establish a mealtime schedule that aligns with your daily routine. Consistency can help manage the process effectively and reduce stress.
Prepare in Advance: Pre-fill Bolee Bags with the appropriate amount of nutrition or water and store them in the refrigerator. This can save time and make the process smoother.
Maintain Hygiene: Wash your hands thoroughly before and after handling food and supplies.
Comfortable Environment: Create a comfortable environment for mealtime to help reduce stress for both the caregiver and the individual receiving the feeding.
Positioning: Ensure the person receiving the tube feeding meal is in a comfortable and appropriate position. This may include sitting upright or reclining slightly, depending on their comfort and medical needs.
Monitor for Complications: Keep a close eye on the person's condition and watch for any signs of complications such as vomiting, diarrhea, or discomfort. Report any concerns to their healthcare provider promptly.
Seek Support: Don't hesitate to reach out to healthcare professionals or support groups for guidance and assistance. They can provide valuable advice and help troubleshoot any issues that arise.
Stay Organized: Keep a log of mealtimes, amounts administered, and any observations or concerns. This can help track progress and identify any patterns or issues that may need attention.
Take Care of Yourself: Caring for someone who requires tube feeding can be physically and emotionally demanding. Make sure to take breaks, prioritize self-care, and seek support from friends, family, or professionals when needed.

By implementing these tips and strategies, you can help make home tube feeding easier and more manageable for both the caregiver and the individual being tube fed.

Bolee Bag & Bolink Caps Support You

Bolee Bags and Bolink Caps are:

Environmentally friendly
Portable
Less messy than bolus syringes
Easy to use
Covered by insurance if supplied by a DME

Reducing Home Tube Feeding Medical Supplies

Fri, 01 Mar 2024 17:47:10 GMT

Reusable Tube Feeding Supplies

Home tube feeding patients use a lot of medical products that are designed for one-time use, generating more waste going to the landfill. Increasingly, caregivers are quite conscious of this and are looking to reduce their plastic footprint.

We had this in mind when we designed the Bolee® Bag. It’s made out of sturdy polyethylene which stands up to multiple uses and being stored filled with nutrition in a refrigerator or freezer.

The Bolee Bag can be reused at least 15 times. At three meals a day that means you will only use 73 Bolee Bags per year versus 365 traditional gravity bags.

The Bolee Bag can hold 375mL, which is the size of a typical tube feeding meal. It would take over six 60mL syringes to deliver that same meal. One Bolee Bag used 15 times replaces filling 93 bolus syringes!

Bolee Bags and Bolink Large Caps are:

Environmentally friendly
Portable
Less messy than bolus syringes
Easy to use
Covered by insurance if supplied by a DME (HCPCS B4036)
Available through Coram, Lincare, Aveanna,PHS and other DMEs.

Gravity Tube Feeding Prescriptions Give Patients Flexibility Compared to Bolus Tube Feeding Prescriptions

udelivermedicalllc@gmail.com (U Deliver Medical) — Thu, 01 Feb 2024 19:47:09 GMT

Gravity Tube Feeding Supply Kits Contain Everything

Home tube feeding prescriptions are written based on the type of delivery being utilized by the patient - Gravity, Bolus or Pump. Insurance companies typically only pay for one mode of administration so this decision is critical. A mixture of pump, bolus and gravity supplies cannot be sent to the patient. . The prescription goes to a Durable Medical Equipment (DME) company and that tells the DME what type of enteral nutrition delivery supplies to send send to the patient each month.

Pump supplies are typically prescribed for patients who need very slow nutrition delivery over a long period of time or don't have an active caregiver so the pump is programmed to deliver nutrition.

Active patients typically choose between bolus (syringe) or gravity tube feeding. The Bolee® Bag and all Bolink® Caps are reimbursed by insurance as gravity tube feeding products but have the flexibility to function as gravity or bolus.

A Gravity Kit (B4036 or S9341) with Bolee Bags and Bolink Large Caps and/or the Bolink D Cap and/or the Bolink Small Cap gives your patients options:

Bolee Bag and a Bolink Large Cap work with all nutrition from homemade blends to standard formulas.
Bolee Bag and a Bolink Large Cap is flexible so they can be used for gravity tube feeding or bolus tube feeding.
Bolink D Cap gives the same options with the the direct connect advantage when prescribed with Kate Farms or Nestle HealthScience cartons.
Bolink Small Cap provides a direct connect advantage when prescribed with the Kate Farms Blended Meals pouch.
Syringes for flushing are included in the gravity kits so patients can syringe feed if needed

Prescriptions for gravity tube feeding with Bolee Bags and Bolink Caps give patients all of the products and the flexibility they need to gravity or bolus tube feed. Why prescribe anything else?

Transitioning from an Enteral Pump to Gravity Tube Feeding

udelivermedicalllc@gmail.com (U Deliver Medical) — Thu, 11 Jan 2024 16:51:43 GMT

Let the Bolee Bag and Bolink Caps Make it Easier

Recently, we’ve had many conversations with clinicians and caregivers about using the Bolee Bag and Bolink Caps to transition patients from a pump to gravity tube feeding. Making that transition can be hard for many reasons.

Changing the delivery method can impact the formula choice and tolerance.
Pumps can be very convenient, especially when feeding standard formulas as that’s what most of them are designed to deliver.
Patients come out of the hospital on a pump and caregivers think that a pump is “what the doctor ordered” and therefore are reluctant to change.
Bolus and gravity feeding, especially with a syringe can be very labor intense and messy.
Bolus and gravity feeding is hard for patients to do on their own, meaning more work for the caregiver.

Bolee® Bags and Bolink® Caps can make the transition easier.

First of all, the messiness factor can be pretty much eliminated. Pour all the nutrition needed for a meal into a Bolee Bag, attach a Bolink Large Cap, connect to a feeding tube or extension set and you’re good to go. For Bolink D Cap it’s even simpler because there’s no pouring. Just attach, connect and feed.
Same goes for the amount of effort. There’s no “rinse, repeat” cycling like with a syringe that take 6 syringes to deliver a meal.
Bolee Bags and Bolink Caps are versatile and convenient. They work with all nutrition and can be used anywhere.
Finally, except for the youngest of patients, most patients can manage the delivery without any assistance.

So the next time, you’re transitioning a patient from a pump, think Bolee Bag and Bolink Large Cap. It will make everyone’s life easier!

Whole Foods Tube Feeding

udelivermedicalllc@gmail.com (U Deliver Medical) — Mon, 20 Feb 2023 19:29:20 GMT

Whole Foods Tube Feeding

Commercial whole foods tube feeding refers to the use of pre-made, commercially available whole food products specifically designed for individuals who require tube feeding for nutritional support. These products may include pureed fruits and vegetables and other meals that are made with whole, natural ingredients and are free from artificial preservatives or additives. They are typically packaged in pouches and can be delivered through a nasogastric or gastrostomy tube.

Whole food tube feeding can provide a more natural and varied diet for individuals who are unable to eat by mouth, and can help to improve overall health and well-being.

Some Issues to Manage

There are many benefits of a whole foods tube feeding nutrition diet but there also some issues to manage:

Inconsistent Consistency : The production process for whole foods will vary depending on the ingredients in the pouch, making some pouch contents thicker than others. You will probably need to add liquid to thin the nutrition out for gravity or bolus tube feeding with the Bolee Bag and Bolink Large Cap . The large opening of the Bolee Bag makes it easy to transfer from the pouch and add extra liquid.
Nutrient Deficiencies : Some brands may not provide all of the necessary daily nutrients for a person who is solely tube-fed. The Bolee Bag makes it easy to add extra ingredients to make sure the daily intake is correct.
Pesky Pouches : Whole foods are packaged in pouches that can be difficult to manage tube feeding delivery but the Bolee Bag makes it easy. Just cut the corner of the nutrition pouch with a clean scissors to make a spout for pouring into the Bolee Bag . There is also a funnel to make the Bolee Bag opening even larger.

Benefits

Some of the reported benefits of whole food tube feeding are:

Regularity : Reduced constipation and diarrhea
Skin: Healthier, more elastic skin
Phytonutrients : Whole foods contain phytonutrients and fibers that aren't found in synthetic formulas
Variety : There are many different food combinations available to give the body a variety of nutrients

Market Shift

The home tube feeding market appears to be shifting to more use of commercial whole food products and homemade blenderized nutrition. The variety of commercial whole foods and homemade blenderized nutrition helps make home tube feeding more natural and similar to the diets of people without feeding tubes.

As this shift takes place, traditional methods of nutrition delivery (bolus syringes and gravity bags with five feet of tubing) are becoming obsolete. This is why the Bolee Bag and Bolink Caps were made.

Discover the nutritional benefits of whole foods tube feeding and the freedom provided by Bolee Bagsand Bolink Caps .

Direct Connect for Easy Tube Feeding

Thu, 17 Nov 2022 21:41:39 GMT

Direct Connect for Easy Tube Feeding

Why didn't anybody think of this before? Many tube feeding nutrition products are packaged in the same type of container but nobody thought to design tubing that would on one end, screw on to the container and on the other end, screw onto an ENFit feeding tube or an ENFit extension set. It seems so obvious that this would be a better way to deliver tube feeding nutrition compared to pouring it into a bolus syringe or gravity tube feeding bag.

This is the Bolink® D Cap - the first gravity tube feeding nutrition delivery product that connects a Tetra nutrition container to a feeding tube or extension set.

What is this Container?

The container is called a Tetra DreamCap and it's easy to spot by the plastic lip that comes over the front edge of the carton.

Why is this a Better Way for Tube Feeding?

Tube feeding can be a messy process, especially if you are trying to manage a child at mealtime or if you have general dexterity issues. Trying to pour a carton into a bolus syringe takes both steady hands and focus. if you're shaking or get bumped there is an immediate mess.

With the Bolink D Cap, once you screw the cap onto the container, the mess from spills is eliminated. After that, once you screw the ENFit end onto the feeding tube or extension set, nutrition delivery can begin and you control the flow speed by how high the container is above the stoma site. This makes it easy to have a tube feeding meal where ever you want - home, school, work, airplane, bus, car, truck, museum, art gallery, restaurant, the park...

What About Hydration?

After you're done with your meal you need water. To make it easy, all you have to do is put water in the empty nutrition container and reattach it to the Bolink D Cap. This cuts down on waste by eliminating extra syringes just for flushing.

Frequently Asked Questions:

Q: Can the Bolink D Cap be reused?

A: Yes, it can be reused multiple times in the same day with rinsing between uses, but use a new Bolink D Cap each day.

Q: Does the roller clamp control the flow rate?

A: The roller clamp is used to start and stop the flow of nutrition.

Q: Is the Bolink D Cap covered by insurance?

A: Yes, if it is provided by your DME or home infusion company, they can bill your insurance.

Q: How do I get a prescription to give to my DME or home infusion company?

A: Ask your health care provider to prescribe gravity tube feeding using the Bolink D Cap - 30 per month.

Q: Can I buy the Bolink D Cap online?

A: Yes, it is available at udelivermedical.com or Amazon.

Q: Do I need a prescription to buy the Bolink D Cap online?

A: No, the Bolink D Cap is and over-the-counter product so no prescription is needed to purchase it online.

Blenderized Tube Feeding

Tue, 02 Aug 2022 18:51:58 GMT

Blenderized Tube Feeding Made Easy

Blenderized tube feeding (BTF) is getting more and more popular with home tube feeders. It is getting so popular that the large nutrition companies (Real Food Blends, Functional Formularies and Nestle HealthScience) are mass producing whole food tube feeding products that are very similar to home blends. Clinicians are also taking notice with many new clinical studies being published on the benefits of a blenderized tube feeding diet.

A recent study was conducted with 30 tube fed head and neck cancer patients who switched from a standard commercial tube feeding to a commercial BTF formula. Sixteen of the patients finished the study and reported excellent results with regard to weight gain, reduction in GI complications (pain, bloating, vomiting, constipation and diarrhea) and improvement in quality of life. Here is a link to the study publication - Blenderized food tube feeding in patients with head and neck cancer - PubMed (nih.gov)

U Deliver Medical saw this trend starting a few years ago, which is why we created the Bolee Bag and Bolink Large Cap .

The Bolee Bag is reusable up to 15 times and can be used to store home blenderized nutrition in the refrigerator or freezer
Here is a link to a clinical report on reusing Bolee Bags - Low risk for microbial contamination of syringe and tube feeding bag surfaces after multiple reuses with home blenderized tube feeding - Milton - 2022 - Nutrition in Clinical Practice - Wiley Online Library
Delivering one full Bolee Bag with a Bolink Large Cap at mealtime instead of dipping, filling and pushing 6 -7 syringes, makes mealtime easy
The Bolee Bag and Bolink Large Cap are covered by insurance if supplied by a DME
The Bolee Bag and all Bolink tubing products are sold as over-the-counter products and can be purchased through our website or Amazon

Here is a video demonstrating how easy it is to use U Deliver Medical products with home blenderized nutrition or commercial food pouches:

Homemade blenderized tube feeding nutrition has significantly grown in popularity and we expect to see continued growth as clinicians get comfortable managing patients using this source of nutrition. U Deliver Medical has the products needed to efficiently deliver homemade blenderized tube feeding nutrition.

Is my Bolee® Bag Clean?

Fri, 04 Mar 2022 22:11:15 GMT

Safe Use of the Bolee Bag

Is my Bolee Bag clean? That's a question that comes up from time to time from customers. Specifically, caregivers ask:

How many times can I use the Bolee Bag?
How do I keep the Bolee Bag clean after use?
Is it safe to reuse the Bolee Bag multiple times?

We do have recommendations on how many times the Bolee Bag can be use based on testing we've done (See below) but for the cleaning questions we thought it best to go a respected clinical person who has studied that topic to learn more.

The Bolee Bag is designed to last

The Bolee Bag is designed to be reused. It is made from sturdy plastic film with extra wide seams around the edges to make sure that it stands up to home use. To make sure we got this right we tested it using a cycle of fill, empty, wash, rinse and dry. We did this cycle 15 times on multiple Bolee Bags and then tested them for any leaks. We also put the Bolee Bag through freeze and thaw cycles to make sure that storing them in freezer will work. The good news is that the Bolee Bags performed very well, with no leaks to validate the design during development. Feedback from customers indicates that the Bolee Bag typically outperforms the 15 uses with appropriate care. To make sure we maintain this high level of performance, we track and investigate all complaints

Cleaning the Bolee Bag

Cleaning the Bolee Bag after it's used and maintaining its cleanliness over time is also important. We know from the caregivers that using the instructions on the back of the Bolee Bag - wash with warm soapy water, rinse and air dry - make it possible to keep nutrition free from contamination. But you don't have to take our word for it. Dr. Teresa Johnson, a registered dietitian who teaches and does research at Troy University, has demonstrated that by following the Bolee Bag cleaning instructions, the Bolee Bag remains clean.

She, Dr. Debra Milton from Umea University in Sweden and their teams performed a controlled study which evaluated the risk of contamination when using the Bolee Bag for tube feeding. The results of their study were published in Nutrition in Clinical Practice (March 2022). The article is " Low risk for microbial contamination of syringe and tube feeding bag surfaces after multiple reuses with home blenderized tube feeding ". The team simulated 15 tube feedings in their lab and tested the Bolee Bag and syringe for bacterial contamination before and after the 15 feedings. Dr. Johnson concluded that both Bolee Bags and ENFit® bolus syringes may be used multiples times for BTF with a reduced risk of microbial contamination when following the US Food Code guidelines for safe food preparation and manufacturer’s cleaning guidelines between uses. The article points out that the nutrition wasn't tested for contamination, just the surfaces of the Bolee Bags and syringes. Also, the ENFit syringe used in the study also was not labeled for reuse.

Storage

In 2020, Dr. Johnson also published an article in Nutrition in Clinical Practice titled "Accepted Safe Food-Handling Procedures Minimizes Microbial Contamination of Home-Prepared Blenderized Tube-Feeding" . In this article she reported on the work she and her team at Troy University did to demonstrate how best to prepare and store home blended tube feeding. They show that using standard food safety processes, it is possible to prepare and store tube feeding safely for up to 48 hours in a refrigerator. And they used the Bolee Bag as the food container in their study. One of the most critical aspects of safe storage of the tube feeding is starting with ingredients that are free from contamination and carefully maintaining standard food safety practices during preparation.

Both articles provide support for the reuse of the Bolee Bag for tube feeding as long as you follow instructions and take care when preparing home blends and handle commercial tube feeding appropriately.

If you follow these commonsense directions , you can answer the question that started this blog - Is my Bolee Bag Clean? - with an enthusiastic - YES!

A Crash (and no way comprehensive) Course in the History of Tube Feeding

Mon, 14 Feb 2022 15:43:34 GMT

A special guest post from Melanie Dimmitt

For those of us approaching a feeding tube with trepidation, it may be heartening to know that, 80 years ago, ‘rectal feeds’ were all the rage. Up until the 1940s, enteral nutrition was delivered via enema - in its earliest form, it’s believed the ancient Greeks and Egyptians used animal bladders to achieve this - but the surgically placed feeding tubes of today have their roots in the mid-to-late 1800s.

Nasogastric feeding tubes debuted more than two centuries earlier when, in 1617, Italian surgeon Girolamo Fabrici d'Acquapendente proposed treating tetanus with a ‘small, curved silver cannula, through which we introduce the food in liquid form directly into the palate, passing through the nostrils’. However, old mate Girolamo might be peeved to know that US physician Abraham Louis Levin, inventor of the Levin tube in 1921, is acknowledged as the father of the NG-tube.

Back in the 1800s, most attempts at gastrostomies didn’t end well, but let’s not lose sleep over 19th century wound contaminations. Instead, allow me to introduce Dr Lycurgus Lafayette Staton who, in 1870, became the first American surgeon to perform a gastrostomy without spelling a swift end for his patient - an eight-year-old boy with esophageal stricture (abnormal narrowing or tightening of the oesophagus). Within two months of his surgery that boy was chewing his food and injecting the resulting purée into his tube.

This could have been the first instance of ‘blenderised feeds’ if it weren’t for a man called Jan Baptist von Helmont. In 1646, this Belgian chemist fashioned a leather, hollow tube which patients would swallow before syringing through blended food - perhaps also prepared in their very own mouths.

Let’s pause here for a moment to appreciate the modern, mastication-free marvels that are high-performance blenders.

The first successful jejunostomy - a gastrostomy which goes into the top of the small intestine instead of the stomach - was performed in 1858. But it wasn’t until 1891 that Oskar Friedrich Witzel, a German professor of surgery, developed the most commonly used jejunostomy insertion technique.

Meanwhile, I’m sorry to report that rectal feeding was still around. In 1881, for a whole two months after being shot, it kept former US president James Garfield going on a diet of beef broth and whiskey before he died of sepsis.

In 1894, American gastric surgeon Martin Stamm published his description of a gastrostomy performed on a dog which, would you believe, with only minor tweaks is still widely used today.

Things dilly-dallied (rather direly) along until the 1940s, when the onset of modern antibiotics meant that patients needn’t perish from infections.

Later in this decade, flexible polyethylene (PE) tubing and feeding pumps also entered the scene. Then the space race of the ’60s saw astronauts in need of easy, portable nutrition - sparking the origins of enteral feeding formulas.

The ’70s saw nasojejunal tube-feeding starting to be used in paediatrics and, in 1979, two surgeons in Cleveland, Ohio, developed and performed the first percutaneous endoscopic gastrostomy (PEG) on a six-month-old baby. Prior to this, placement of a gastrostomy required a laparotomy - open abdomen surgery - to get the job done.

The PEG-tube insertion is now a routine medical intervention. This was the kind of surgery my son, Arlo, had in 2021 - a procedure that Arlo’s Sydney-based paediatric surgeon informed me he performs at least once a fortnight.

There is very little data indicating how many people are currently tube-fed in Australia and New Zealand. However, based on data from the US, where about half a million children and adults rely on feeding tubes, we can estimate that 0.15 per cent of Australians and New Zealanders are in this cohort. That’s around 45,000 people. And this number is growing.

So, to those who are fresh to the tube-feeding space, know that enteral feeding is as old as time (we’re talking 3500 years, at least). While the ins and outs can seem daunting - certainly at first - using a tube to feed isn’t that uncommon and, contrary to how you might feel now, you are far from alone in this experience.

Tube-feeding is now only getting slicker and more sophisticated. And one thing’s for sure, having been unquestionably superseded by modern medicine, rectal feeding is thankfully a thing of the past.

This article was originally published in The Blend magazine, a free resource for parents and people in the tube-feeding community, created by Melanie Dimmitt, an Australian freelance journalist. Since launching her debut book, Special: antidotes to the obsessions that come with a child’s disability , Melanie has written, spoken, podcasted and advocated far and wide for parents travelling not-so-typical paths.

The following studies and articles were very helpful in putting this article together:

Hejyork, A. (2020, July 18). A short history of feeding tubes. Retrieved July 04, 2021, from https://unlockingwords.wordpress.com/2019/03/31/a-short-history-of-feeding-tubes/

Minard, G. (2006, December 1). The History of Surgically Placed Feeding Tubes.

Retrieved July 04, 2021, from https://doi.org/10.1177/0115426506021006626

Chernoff, R. (2006, August 1). An Overview of Tube Feeding: From Ancient Times to the Future. Retrieved July 04, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136860/

Zampetti, P. (2020, August). Girolamo Fabrici d’Acquapendente’s “nasogastric tube” Strategies for artificial nutrition between the XVI and XVII centuries. Retrieved July 04, 2021, from https://mattioli1885journals.com/index.php/MedHistor/article/view/9420

D'Cruz, J. (2021, January 16) Feeding Jejunostomy Tube. Retrieved July 04, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK562278/

Ponsky, J. (2011, Apr-Jun). The Development of PEG: How it was. Retrieved July 04, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136860/

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Photos and illustration added by U Deliver Medical.

Keeping Commercial Tube Feeding Safe

Tue, 14 Dec 2021 19:52:56 GMT

Reducing Contamination Risk while Increasing Ease of Use

Connect Directly, No Pouring Required

Over the years clinicians and companies have spent a great of energy and work on creating tube feeding systems that protect patients from the risk of receiving contaminated nutrition during tube feeding. The products developed - pumps, sets and containers - are designed primarily to create a closed system which reduces the amount of handling of the tubing and nutrition container, extends the length of time a bag of nutrition can be used and makes the process easier for stressed out nursing staffs in hospitals and nursing homes. These products create a closed fluid path for the nutrition to travel from its sealed container through to the feeding tube. This design protects the sterile nutrition from exposure to external air and lowers the risk of contamination during feeding, which can be as long as 48 hours.

As we bl ogged a year ago, those products are great for the patient and the nursing staff in an ICU with a serious illness like COVID or bed ridden in a nursing home. But if you're at home, relatively mobile and following a tube feeding schedule of 3 meals a day with snacking in-between, such a design doesn't work for you. We proposed last November that the bFed® System gives you a way to lower the risk of contamination both during prep and delivery as well as the ease of use of the hospital based closed system products.

With the introduction of the Bolink® D Cap, there's an additional bFed System way to create a closed system when using packaged commercial tube feeding nutrition at home.

Connect Directly, No Pouring Required

Just like the closed system designed for pump use, the Bolink D Cap creates a fluid path for the sterile commercial formula to travel from its Tetra container to the feeding tube. This helps to reduce the risk of contamination in two ways:

The tubing is connected directly to the tetra so there's no pouring of the nutrition into a container.
The vent in the cap allows filtered air into the container during feeding.

But with some important differences designed for at home use:

The tubing is shorter and designed for home tube feeding.
The Bolink D Cap attaches to Tetra cartons with the DreamCap, which are single servings so there's no need to store left over nutrition. It's ideal for the type of meals (intermittent feeding) prescribed for patients at home.
There's no pump needed to control the flow rate, instead you raise the Tetra to speed up the flow or lower it to slow it down. You can also use the roller clamp to adjust the flow.
The tubing is short and easy to flush after you're finished.

It's easy to use. Just remove the DreamCap from the tetra container, screw on the Bolink D Cap, prime the tubing, use the ENFit connect to connect to your feeding tube and it's mealtime. The vent in the cap allows air into the container to maintain a steady flow of nutrition and the roller clamp lets you control how fast or slow the nutrition flows. Before use with thicker and higher calorie nutrition, shake the Tetra. And, it may be necessary to shake or squeeze the Tetra occasionally during use to keep a steady flow. The vent also filters air during the feeding which helps to reduce exposure to potential contamination.

The video below shows how the system works.

As with all bFed System products, the Bolink D Cap makes meal time stress and mess free so you can relax!

Try it out with a 5 pack from the U Deliver Medical store.

It is reimbursed as part of HCPCS Code B4036, so it is covered by insurance if provided by your DME. Ask your healthcare provider to prescribe the Bolink D Cap as part of the monthly gravity tube feeding supplies you recieve from your DME.

Tube Feeding and Meal Time

Wed, 12 May 2021 20:51:02 GMT

"Feeding" or a Meal?

Tube feeding practices and protocols typically flow out of the hospital into home. The assumption is that what works in the hospital for the patients is just fine for people at home. That makes continuous feeding the starting point. Continuous tube feeding usually take place over many hours, maybe even 24, at a very slow delivery rate, less than 75 mLs per hour using a pump. That is fine if you're lying on your back or propped up in an ICU bed with a critical illness and one of 2 or 3 patients being taken care of by one nurse.

For most people at home with feeding tubes (like the bFed® customers pictured above) that isn't the case. They aren't critically ill, are pretty active and are able to take care of themselves or have one-on-one care from a loved one. For them, bolus or intermittent feeding is the way to go.

So why is the medical nutrition community so focused on tube feeding as needing a pump that delivers a continuous amount of nutrition and not the idea of eating "meal" or in clinical language - intermittent feeding? Let's go through some of thoughts behind this bias.

Challenging Conventional Wisdom on Tube Feeding

A pump ensures nutritional goals and just easier to use

Two of the assumptions about the disadvantage of 3 meals and a snack (intermittent gravity or bolus tube feeding)and continuous tube feeding are that you're more likely to meet your calorie goals each day on continuous feeding and it is easier to set up a pump feeding schedule. There have been no specific studies comparing delivery methods and meeting nutritional goals but the assumption is that if you're being continuously fed it is more likely that you'll get enough nutrition because the pump is always dripping formula in.

The problem with that way of thinking is that is assumes that the pump is always on. And it isn't. Every time a pump is stopped for whatever reason, the nutrition stops flowing and no one changes the flow rate to make up the difference. Consequently nutrition targets are unmet. With intermittent feeding, each meal is an opportunity make sure you get all the calories you need by just having a complete meal.

In addition to making it easier to meet nutrition targets, having 3 meals and snacks, has been linked to building and maintaining muscles in a few small studies. The benefit comes from the way proteins are synthesized after a meal vs. during continuous feeding. Another impact of not following a meal schedule is the internal clocks in the different organs that help manage the body functions dependent on nutrition have to adjust and this too may impact critical body functions..

Finally, on paper it may seem easier to set up pump feeding, but the reality is much different, especially when you consider the need to carry a pump, dealing with alarms and worrying about flow rates. Using a Bolee Bag and Bolink Large or a Bolink Small Cap connected to a pureed food pouch is simple, clean and easy to do.

Better Toleration

The next assumption on the list is better toleration. Tube feeding intolerance is best understood as not being able to digest your food and having diarrhea, vomiting, bloating after eating; you get the point. Again the assumption is that a slow delivery on tube feeding will make it more "tolerable". Studies again show that at least for hospital patients, there's no difference between continuous and intermittent feeding. From a reading of the literature on the subjects, the experts aren't clear on the connection delivery method and intolerance. In fact some think that there may be a benefit having tube feeding meals.

Better Blood Sugar Managment

Diabetes management is another reason that clinicians like continuous feeding over having tube feeding meals. If you're diabetic managing your sugar levels is critical to maintaining your health. Many clinicians believe that by using a continuous tube feeding schedule provides less variability in sugar levels and makes management easier, but that may be because most protocols for managing glucose levels while tube feeding are built around continuous feeding. Newer studies have shown that there may be no advantage to continuous feeding and that intermittent feeding may work just fine, especially for tube feeders at home. For the none tube fed world, blood sugar levels are managed quite well with the normal eating of 3 meals a day.

Reduction in aspiration risk

The final issue is tube feeding aspiration (having formula or nutrition enter the lungs) is one of the reasons why continuous feeding is done instead of letting people with a feeding tube, just have 3 meals and a few snacks. In fact aspiration risk is one of the main clinical justifications to supply a pump and receive insurance coverage for home pump use. The situations that may cause aspiration are related to lying flat on your back in an ICU bed - supine position (clinical speak for lying flat on your back); large diameter tubes (typical of large diameter nasogastric tubes used for gastric feeding in the hospital); delayed emptying, decreased consciousness and ileus (typical side effects of medications, surgeries and sedatives used to treat critically ill patients).

That's not to say that tubies at home don't have a risk of aspiration. If you eat too fast, quickly fill your stomach and lie down, you may aspirate. On top of that tube feeding is liquid, creating more risk for aspiration, especially if you deliver it too quickly. So the way to avoid this is to follow the advice we all heard from mom, "Slow down, don't eat so fast and enjoy your meal. It's not a race".

Enjoy Your Meal

At the end of the day, delivering your tube feeding by having meals and snacks is just fine. There's no need for a pump and the extra work it brings to the party. Following a meal schedule is just fine, using a intermittent feeding delivery system to make it happen. Over 60% of the people using feeding tubes to provide nourishment do it this way. A meal together with your family and friends is the most natural thing to do. And, the bFed System can help you do this. There's no need for messy syringes with the need to fill and refill or try to pour the nutrition down the syringe.

U Deliver Medical puts the "YOU" in tube feeding.

Feeding Pumps - Friend or Foe of the Bolee Bag and Bolink Caps?

Mon, 15 Mar 2021 19:05:15 GMT

Exploring Your Nutrition Delivery Options

For 60% of people who rely on a feeding tube and use bolus or gravity for nutrition delivery, the Bolee Bag and Bolink Caps are a source of freedom to eat what they want, when they want, and where they want . All they need to enjoy a meal is a Bolee® Bag and a Bolink® Large Cap.

The other 40% of tube feeders use a pump for their nutrition delivery. There are many good reasons for using a pump - lowering the risk of aspiration, overnight feeding to ensure sufficient calories to maintain health or having a slow and steady flow of nutrition to tolerate tube feeding - to name a few.

But with that said, does it mean that the Bolee Bag and Bolink Caps has no role for this group? We like to think not.

Overnight Continuous Feeding

Some people use a pump for overnight feeding. Overnight feeding with small meals during the day is a way to deliver enough calories to keep healthy while not being tied to a pump during the day. By doing this, the tube fed person receives a slow continuous flow nutrition all night long controlled by a pump to promote tolerance and and lower the risk of aspiration. The meals during the day are smaller and supplement the overnight feeding. Usually a syringe is used to delivered them, typically at breakfast, lunch and dinner.

Accessorizing Your Pump with the Bolee Bag & Bolink Caps

A Bolink Large Cap and a Bolee Bag or a Bolink Small Cap and a pureed food pouch are the perfect "accessories" for this tube feeding routine. Using the Bolee Bag and Bolink Large Cap instead of a syringe during the day makes mealtime less stressful. There's no more messy syringe to use and it is as clean as pump delivery. Just fill the Bolee Bag with the right amount of nutrition, connect the Bolink Large Cap to the Bolee Bag and feeding tube and let gravity take over. If a smaller meal or snack is all that you need, connect the Bolink Small Cap to a pureed food pouch and a feeding tube, squeeze the pouch to deliver nutrition through your feeding tube.

Acquiring the Bolee Bag & Bolink Caps

Insurance, Tubing Supplies and Home Care Companies (DMEs)

Feeding Pumps require extra clinical documentation to justify their use and to receive insurance coverage under code B9002. And, there is a specific insurance code, B4035, for the monthly supply kit for the tubing and other items necessary for pump feeding. Likewise, the monthly supplies for syringe and gravity delivery have specific kit codes B4034 (syringe) and B4036 (gravity) defined for insurance coverage. Unfortunately, only one tube feeding supply code can applied at a time for insurance coverage for each patient by a homecare company. You can't receive coverage for pump and bolus or gravity feeding. The reimbursement tied to the codes do allow for additional supplies, but home care companies structure their supply kits around the supplies only needed for the particular delivery mode described by the code. There's no "combo" code which allows them to charge for a mix of delivery methods.

Practically speaking, that means if you're overnight pump feeding but syringe feeding during the day, the syringe supplied for flushing or medication delivery in a pump kit has to serve double duty. This is far from an ideal situation. The flushing/medication syringe as a result is going to used a lot and wear out rapidly. With each use, especially when delivering nutrition, it gets harder and harder to push the plunger. The inexpensive syringes provided by most homecare companies are designed for single use. And, it is not a great idea to mix medication delivery with food delivery.

What to Do to Get the bFed System

If you are using a pump and have insurance coverage, but want to use the bFed System for supplemental nutrition, you can try asking your DME to include 2 Bolee Bags and 2 Bolink Large Caps or 4 Bolink Small Caps in your monthly pump supply kit. That's likely to be a frustrating conversation without a positive outcome.

Alternatively, you can avoid struggling with your DME and buy bFed System products from our online store or the bFed System store on Amazon (click on the buttons below to learn more). Remember bFed System products are reimbursable as durable medical equipment so you may be able to use FSA or HSA credit cards to pay for them.

Whatever you decide to do, having the Bolee Bag and Bolink Caps on hand will provide you with another option in addition to you pump to eat what you want, where you want. Experience the freedom today!

The Problem with Bolus Syringes

Wed, 20 Jan 2021 20:39:00 GMT

The problem with catheter tip bolus syringes is that they weren’t designed for the bolus delivery of nutrition!

Bolus syringes are incredibly inefficient. The typical bolus syringe is 60mL, which is great for hydration or many enteral medications but not for a full meal. They aren’t designed to be used multiple times either – the rubber tip on the plunger wears out quickly making it almost impossible to push. They were designed to deliver meds or hydration and then thrown away, not refilled and used over and over.

A larger bolus syringe isn’t the solution either because it gets very difficult to to push the plunger. If you don’t use a plunger it gets tiresome to sit and hold a large volume syringe while it slowly drains.

The Miracle Syringe?

A lot of people like the Miracle Syringe from the Squirrel Store. It has an o-ring instead of a large rubber tip on the plunger, which makes the syringe somewhat easier to use and longer lasting. But, bottom line, this syringe is designed for veterinary use! If you shop for them on Amazon the first bullet point says “Not for human use-animal hand feeding only.”

Is that really what you want to use for yourself or your loved one at meal time?

Keep it Clean

No matter what type of syringe you use for bolus feeding you have to connect and reconnect many times during a meal. This means dipping the syringe into the nutrition, cleaning the tip and connecting it to your feeding tube. With each connection, the chance of contaminating the nutrition increases.

Reducing the number of times you need to connect and disconnect with a messy tip is best way to keep your feeding tube clean and lower the risk of contamination.

ENFit Syringes

ENFit syringes are great for making a secure connection but doesn’t change the fact that you have to disconnect and refill the bolus syringe up to six times at every meal. ENFit syringes have threads to make a secure connection, but that also makes keeping the tip clean a challenge. The nutrition on the tip can transfer to the groove in the ENFit connector on the feeding tube. The nutrition then builds up in the groove and can create a hard to clean residue.

If you don’t have an ENFit feeding tube or extension set yet you can still use the bFed® System – just make sure to add an ENFit adapter to your order.

The Alternative

All of these difficulties in using bolus syringes are why we created the bFed® System – designed specifically for the home tube feeder. Using the Bolink® Large Cap and a Bolee® Bag or Bolink D Cap with nutrition in a tetra with the DreamCap means no messy tip and less chance for dried nutrition to build up in the ENFit system. There’s no dipping a tip into the nutrition.

You now have many meal time bFed System options.

Pour your nutrition into the Bolee Bag, attach the Bolink Large Cap and connect to the feeding tube or extension set to deliver your nutrition – one connection per meal.
If your nutrition is in a tetra with the DreamCap, screw on the Bolink D Cap, connect to the feeding tube or extension set and you're good to go!
You can also fill multiple Bolee Bags and store them in your refrigerator or freezer. Easy to grab for a day on the go or storage at school or work.

The Bolee Bag is also easy to wash and reuse. We’ve tested it through multiple fill, freeze, use and wash cycles and are confident you will get on average 15 uses out of each Bolee Bag (some will get more, some will get less). You will appreciate not having to throw away so many bags.

And, best of all, the bFed System is covered by insurance. If you use a DME , you can get the bFed System delivered to your home as part of your monthly Enteral Nutrition Gravity Supply Kit with the cost covered under HCPCS code B4036 .

Since the Bolee Bag is reusable, most home care suppliers will provide 10 Bolee Bags and 30 Bolink Large Caps for your monthly supply.

Get Rid of the Messy Syringe

Why put up with the misery and mess of bolus syringes? You finally have an alternative to the inefficiency that is bolus feeding with a 60mL syringe. Put down the syringe and get the bFed Syste m today! Either the bFed System Starte r Kit or a Bolink D Cap 5 pack is a great way to get started!

Still Have to use a Syringe?

Sometimes as much as Team bFed hates to admit it, some folks just prefer a syringe to deliver nutrition. For this group we have a solution, the NeoConnect at home ENFit Syringe. Like the Miracle syringe, it has an o ring design and is designed to be reusable. There's no large rubber tip to wear out quickly and make it hard to push the plunger. But, unlike the Miracle syringe, the NeoConnect at Home ENFit syringe is cleared for human use by the FDA . You can have confidence using a product designed specifically for the home tube feeder. These are the reasons U Deliver Medical decided to include it on our online store.

Even with these improvements over the existing syringes, the NeoConnect at home ENFit Syringe can be messy! The ENFit tip is a challenge to keep clean. Team bFed has a solution for that as well - the EZ Fill Kit. Fill a Bolee Bag with nutrition, attach a ENFit transfer lid and fill your ENFit syringe from the Bolee Bag without having to dip the tip into a nutrition container! The video below shows how easy it is to do.

Click on the button below to go to the U Deliver store to check out all the options available we have to help you get rid of messy syringes.

Navigating TSA check points with Tube Feeding Supplies

Wed, 20 Jan 2021 17:32:00 GMT

Now that the world is opening up and we're all getting back to traveling, it is helpful to revisit tips for flying with a feeding tube. The challenge is still present, but with proper preparation it can be done. Navigating TSA checkpoints can be especially difficult if you’re not prepared. There are many websites with excellent advice on what to do. These websites TSA , Feeding Tube Awareness and Oley Foundation have excellent suggestions on how to make travel easier.

Prepare for Flying:

At the TSA check point:

Nutrition and medication screening:

Flying with U Deliver Medical Products:

If you are using packaged tube feeding, you have 3 options:

Fill a Bolee Bag , attach a Bolink Large Cap and enjoy your meal.
For nutrition in a tetra with a DreamCap, just screw on a Bolink D Cap and it's meal time.
If prefer an ENFit syringe, fill a Bolee Bag , attach an ENFit transfer lid to the Bolee Bag, fill your syringe and start your meal, repeating the filling process until the Bolee Bag is empty.

Here are some videos that show how to fill your Bolee Bag before leaving for the airport and to use it once you're on the plane or at the airport to have meal by connecting it to a Bolink Large Cap or filling an ENFit syringe using an ENFit transfer lid. The last video shows how easy it is to use the Bolink D Cap with a tetra that has a DreamCap.

Hopefully the above tips and traveling information on the other websites we referred to will make your trip through the airport just a little bit easier! Click on the button below to go right to the U Deliver Medical online store.

Making Connections - Bolink Caps to Extension Sets and Feeding Tubes

Mon, 18 Jan 2021 19:33:56 GMT

Plumbing Should be Simple

Tubies, some who uses a feeding tube to obtain nutrition, very quickly becomes an expert tube feeding "plumber". Maintaining your tubing means learning all the hacks and work arounds needed to keep your tubing connected and working. Connecting a Bolink® Large or Small Cap to your to your feeding tube or extension set is easy and not a "plumbing" challenge, but right now it could be confusing. The tube feeding market is in the middle of converting to the new ENFit® connector system. To learn more about ENFit, click here to read our blog on it. Some of the advantages of ENFIt are:

The connection between feeding tubes and delivery systems is more secure, so the tubing doesn't pop off or leak;
A more secure connection makes clearing tube clogs easier because you can aggressively flush the tubing without worrying about leaks at the syringe/tube connection;
Misconnections with other tubing systems like I.V. tubing are pretty much eliminated as ENFit isn't compatible with the luer connector on I.V. tubing;
ENFit is standardized so every manufacturer's tubing has the same dimensions making connections between all feeding tubes, tubing sets and syringes universal, which is great for all tubies!

Communication about ENFit has been very uneven especially now in the midst of a pandemic, which complicated it even further. As a result, new supplies sometimes show up without any warning or explanation. Or, even if your home care company let you know about ENFit, there are no directions or the directions you receive, don't make sense. Bottom line, it is hard to figure out which parts go together and how to connect them.

To help you out we've created two short videos that show how to connect the Bolink tubing (Large or Small Cap) to G tubes or extension sets used with Low Profile Tubes (MIC-Key® or Mini-One®).

Connecting to a Funnel Extension Set or Feeding Tube

Feeding tubes with a funnel are what people are used to. To connect tubing to it, all you do is plug the "Christmas Tree" (pictured above) or a catheter tip syringe into the feeding tube and you're set. If you're using a Bolink Cap with a funnel feeding tube or extension set, you have to screw an ENFit adapter on to the ENFit connector on the tube as shown in the picture above. You can buy the ENFit adapter from our store or, if you are getting the bFed System from a home care supply company (DME), you'll have to request that ENFit adapters be included in your monthly kit.

The video below shows how to connect a Bolink Cap to a feeding tube or extension set. Since extension sets come in different lengths and designs, we've included a few different brands in the video. One note, for the best nutrition flow always use a bolus extension set with a straight tip.

LEAK ALERT!

Don't Attach Bolink Tubing to a Funnel Port using the ENFit Connector!

Even though it looks like an ENFit connector should fit snuggly into the funnel port on a extension set, it doesn't . The threads on the ENFit connector do not match the grooves in the funnel port on the extension set. The two parts do not connect securely enough to create a seal. Once nutrition starts flowing you'll have mess on your hands.

Using the ENFit System to Connect

During the next 12 months conversion to ENFit will speed up which means at some point in 2021 your feeding tube and delivery system will change to ENFit. If you're using the bFed System, you'll be ready to go as it is ENFit compatible already. The pictures above show how the connection works for G Tubes and Extension Sets for MIC-Key or Mini-One tubes. For MIC-Keys and Mini-One the good news is that your tube won't change in the conversion, only your extensions sets will change.

To help you sort this out, we created a second short video showing how to connect ENFIt connector on Bolink Caps to different types of ENFit tubes and tubing.

"Tube Feeding Made Easy"

The Bolee Bag & Bolink Caps as a Closed System - Clean Tube Feeding

Thu, 07 Jan 2021 21:58:21 GMT

Keeping Tube Feeding Delivery Clean

In the Hospital

In the hospital tube feeding is handled much like medicine such as antibiotics. It is packaged in special containers and delivered via an infusion pump at a prescribed rate. The connections for the tube feeding closed system used in hospitals and nursing homes are all about maintaining a "closed" fluid path for the nutrition for it to travel from its sealed container through to the feeding tube. The pathway starts at the container with its sterile packaged nutrition. The container is attached to the pump tubing using a special tube feeding "cross spike". The other end of the pump tubing connects to a feeding tub with a using either ENFit or Christmas Tree design connector.

This "closed system" protects the sterile nutrition from being contaminated during feeding, allows it to "hang" on an I.V. pole and be delivered with a pump at slow rate for up to 48 hours. When you're critically ill in an ICU bed, your tube feeding has a specific purpose and must delivered in a precise way to achieve a desired outcome. It is medicine.

At home your nutrition is a very important to maintaining good health, especially if you have a feeding tube, but there's more to it than just "medicine". There's a need for variety in your food and being social. That's why a hospital closed system doesn't work that well at home. A closed system has to be safe, easy to use and flexible like with the Bolee Bag & Bolink Caps.

At Home

Delivering tube feeding at home is all about the meal. In fact, using the word "delivery" feels wrong, but since that's best description for this part of tube feeding, we'll make do with it. In part 1 of "Clean Tube Feeding" we covered filling and storing nutrition using the Bolee Bag. In this part of "Clean Tube Feeding" we'll address different ways to deliver tube feeding with the Bolee Bag & Bolink Caps and how to keep it clean.

Using the Bolink Large Cap

The Bolink Large Cap is easily connected to a filled Bolee Bag and then connected to a feeding tube. Once the Bolink Large Cap is connected to the Bolee Bag and your feeding tube, you have a home tube feeding "closed system". The food in the Bolee Bag now has a protected fluid path, the Bolink Large Cap tubing, to travel to the feeding tube during the course of your meal, preventing contamination during delivery. Remember, touch contamination is when nutrition comes into contact with something in the external environment, like a hand, that could contaminate it. Keeping the nutrition clean with the Bolee Bag/Bolink Large Cap system is a lot easier than using a syringe to deliver 60mLs at time. Each time the syringe is filled or connected to the tube or nutrition is poured down the syringe "funnel" there's an opportunity for contamination.

Using the Bolink Small Cap

The nutrition in pureed food pouches is a great option to include real food into a tube feeding diet. But before the Bolink Small Cap the only way to use this food for tube feeding was to squeeze the pureed nutrition into a syringe and "inject" it into the feeding tube or extension set, 60 mLs at a time. That process provides plenty opportunity for the food to be touched and contaminated.

Screwing the Bolink Small Cap on to the pureed food pouch is not only easier, but it creates a home tube feeding closed system, just like the Bolee Bag and Bolink Large Cap does. The food in the pouch flows directly through the Bolink Small Cap tubing to the feeding tube or extension set without being touched, reducing the chance of contamination during feeding similar to what is done in the hospital. This direct connection to a food container is unique and the only home bolus or gravity tube feeding system that creates such a closed system.

Using the Bolink D Cap

The Bolink D Cap serves as your essential and reliable link between cartons and feeding tubes, designed with both simplicity and functionality in mind. To use it, simply attach the Bolink D Cap screwcap to any carton from trusted brands such as Nestle HealthScience or Kate Farms. Once securely fastened, you can then connect the ENFit end directly to the feeding tube. This creates a clean, closed connection that ensures safety and hygiene, eliminating any concerns regarding spills or contamination that may arise during feeding.

For maintenance, remember to rinse the tubing thoroughly under a faucet, and allow it to air dry completely between uses to ensure its longevity and cleanliness.

The U Deliver Medical tagline is "Tube Feeding Made Easy". That's what the Bolee Bag and Bolink Caps are all about. Listening to people doing tube feeding and approaching it from their perspective creates new options like a "closed system" for at home use.

The bFed® System as a Closed System - Keeping Clean During Prep

Wed, 18 Nov 2020 18:48:53 GMT

Why A Closed System?

In hospitals tube feeding is all about the "Closed System". The products used - pumps, sets and containers - are designed primarily to create a Closed System which reduces the risk of formula contamination, extends hang time and makes tube feeding easier for stressed out nursing staffs. Considering this list of advantages, caregivers and patients at home could similarly benefit from a closed system, especially if it made tube feeding easier and "cleaner" to use. Since most home tube feeding is an intermittent bolus feed without a pump, hang time is not a critical need.

W hat would a home tube feeding closed system look like? At U Deliver Medical we believe that the bFed System is that closed system. The benefits for the home user are protecting the nutrition from contamination, having delivery clean and not messy while keeping the whole process simple and easy. In other words following the U Deliver mantra - "Tube Feeding Made Easy".

Cleaning the Bolee Bag

The most important parts about keeping your nutrition free from contamination are starting out with a clean container and reducing the risk of introducing it while delivering the nutrition. The Bolee Bag is made from food grade plastic and produced in a controlled manufacturing environment so it starts clean. Once you start clean it is important to stay clean. By following the washing and drying directions on the back of the Bolee Bag it is easy to keep clean. You may notice that the Bolee Bag may discolor over time. This doesn't mean that Bolee Bag isn't clean, it is just a result of the nutrition you're using. Tomato sauce, for example, may give the plastic a red tin t.

Filling the Bolee Bag

Filling the Bolee Bag with either commercially produced sterile formula or following safe food preparation in making a home blend is the next step. With "clean" nutrition it is important to be careful when filling the Bolee Bag to avoid what's called touch contamination. Pour directly into the Bolee Bag's large top port being careful not to touch the inside of the bag with your fingers while filling the Bolee Bag. Cutting the corner on nutrition in pouches makes pouring easier. Tetra containers with caps are designed for easy pouring so just remove the cap and pour. If you're using your own blend, using a container with a tip or a funnel to transfer the blend to the Bolee Bag much easier.

Pouring into a Bolee Bag from a Pouch

Pouring Home Blend from its Container

Storing Nutrition in the Bolee Bag

If you want to store your nutrition, you can do that in the Bolee Bag by refrigerating it or freezing it. In a recent research study, a team at Troy University has demonstrated that it safe to store nutrition in the Bolee Bag in a refrigerator for up to 48 hours ("Accepted Safe Food-Handling Procedures Minimizes Microbial Contamination of Home-Prepared Blenderized Tube-Feeding"; Milton, Johnson, et al; NCP; January 2020). Or just place it in the freezer. When you are ready to use it, just remove it from the refrigerator and attach the Bolink Large Cap. If it is frozen simply defrost in the refrigerator over night or place in warm water and attach the Bolink Large Cap.

Clean Tube Feeding

Delivering the nutrition is next part of a closed system. I'll address that in next part of this blog - Clean Tube Feeding.

Tube Feeding Flexibility

Tue, 07 Jul 2020 18:00:00 GMT

Gravity or Bolus?

The bFed® System was developed as a gravity tube feeding delivery system but we have heard from a lot of customers that one of the many things they love about the bFed® System is the tube feeding flexibility to get their food by gravity or bolus.

We like to call this Therapy Flexibility.

Food is important to everyone but when you have a feeding tube it is even more important to get the food you need in the manner that works best for you.

Your Choice

Many times, the food you want will vary from meal to meal and day to day. Sometimes you have a commercial food or blend that is thin and flows by gravity alone. Other times your food is thick and requires a squeeze to flow through the tube. The bFed® System supports whatever you need for that meal.

The home tube feeder has vastly different needs compared to a person in an institution with a feeding tube. We designed the bFed® System to flexible and meet the needs of you, the home tube feeder.

Bolus or gravity? You choose!

The post Tube Feeding Flexibility appeared first on bFed System .

Supporting the Environment

Thu, 18 Jun 2020 20:38:00 GMT

Designed for Reuse

When we were developing the bFed® System, we reviewed all of the different products and how they were used. One of the things that stood out to us was simply how much waste we saw when it comes to medical products.

Of course, some products require a “one-time-use” because of how they are used, however, we found too many products were creating waste due to poor design.

We used this insight to challenge ourselves and change the status quo of daily use tube feeding products to create the Bolee® Bag, the first reusable tube feeding container.

Reduce Waste Going to Landfills

The Bolee Bag is made from food grade polyethylene which is a slightly stiffer plastic than other tube feeding bags, which are made from PVC, so it can stand up when drying and withstand multiple uses. As an added benefit, polyethylene is much more environmentally friendly than PVC.

A couple of things to think about:

Reusing Bolee Bags means that 292 fewer bags per person would be going to the landfills! Just think about that…if just 500 people switched from traditional gravity bags to the Bolee Bag, there would be 146,000 fewer bags in landfills EVERY year!

Spread the Word

We’re doing all we can to spread the word, but we sure could use your help. Please let all your social media friends involved with tube feeding know there is a better, more ecologically friendly option for tube feeding and direct them to udelivermedical.com to learn more.

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Dr. Mark’s Blog – Fred Reuning: Clinical Nutrition Rockstar

Wed, 13 May 2020 15:16:00 GMT

Dr Mark’s Blog

Fred Reuning: Clinical Nutrition Rockstar

May 5, 2020|ROCKSTARS in Clinic Nutrition

Fred Reuning is a nutrition innovation rock star who has contributed significantly to the field of clinical nutrition. He is currently the Vice President of marketing and sales and cofounder with Brian Johnson of U Deliver Medical LLC and has introduced a greatly needed product in the enteral nutrition world; a simple, patient operated delivery system for enteral nutrition. First, let’s look at Fred’s path to success …. It’s fascinating as it involves an international career opportunity and an introduction to silicone, that marvel material of medical devices that set the pathway forward for Fred.

Fred grew up in central Pennsylvania in the shadow of Geisinger Medical Center. His father was a college professor and had a tremendous impact on Fred’s “curiosity gene” and his desire to solve problems. At the age of 13 he was exposed to an international experience when his family moved to Austria. He later attended Washing and Lee University (W&L) and was focused on a career in finance. He took advantage of a program during his college years that allowed him to travel to and study in Vienna for some additional “international experience.”

Once Fred graduated from W&L, he attended Johns Hopkins School of Advanced International Studies to pursue a MA in International Studies and Economics. While at Hopkins he worked for GAO as an auditor of the World Food Program which was his first exposure to nutrition. He remained interested in obtaining further international exposure and education after receiving his MA and entered a program that gave him work experience in Germany. He decided to move to Germany only to find out he had to personally find his “job opportunity.” A daunting task. Fortunately, Fred had family in Germany who encouraged him to at least give it a try …. so, he put together a resume and was stunned to land a position with Bayer the Biochemical/Petrochemical company and was introduced to ……. silicone. Fred worked and learned in Germany and ultimately returned to Boston where he landed a position with a company manufacturing silicone parts for the aerospace and automotive industry (he also got married). One of their suppliers, Dow Corning, encouraged his company to explore the world of medical devices and the need for silicone components. That task was assigned to Fred and began his introduction to the world of medicine.

In 1997 Fred began a career with Novartis/Sandoz as group manager for enteral access devices; this was a time of development for enteral feeding tubes and enteral pumps. Fred and his family moved to Minnesota. It was during this tenure that Fred met Bob Williams at Novartis who became a friend and a mentor. He taught Fred how to ask the right questions and how to seek the right solutions to complex problems. In the year 2000 Fred transitioned his career to Smith Medical where he was director of marketing for vascular access devices. In 2005 he pivoted his career to Vascular Solutions where he was Vice President for their varicose vein therapy business. Still, Fred had the ‘nutrition soul” inside of him. In the year 2009 he accepted a position with Nestle Nutrition where he stayed until 2015 and served as a senior marketing manager for North America on the medical device side focusing on enteral feeding pumps, administration sets and feeding tubes.

The post Dr. Mark’s Blog – Fred Reuning: Clinical Nutrition Rockstar appeared first on bFed System .

COVID-19

Sun, 15 Mar 2020 19:43:00 GMT

Update During COVID-19 Pandemic

We’ve been supplying medical products for a long time and have never experienced a situation like we all find ourselves in today. COVID-19 has generated a lot of worry and quite frankly, panic. We recognize the concern and stress that it’s creating in the tube fed community, especially with regard to obtaining your supplies. Here is our commitment to you, the bFed Community:

Our service to you – We’re small and nimble so it’s easy for us to control our environment to ensure we can continue to fill your orders when received.

Communication – Ensuring effective delivery of nutrition through a feeding tube is critical to maintaining nutrition status and health. We will be honest and open about our ability to supply your needs and will let you know if anything changes.

Guidelines for using the Bolee Bag -To optimize reusability, you should follow the instructions on the back of the Bolee Bag and wash with warm soapy water and let air dry between uses. If you have a concern that extends beyond cleanliness and wish to sanitize, you can disinfect the Bolee Bag using a bleach solution following the instructions on our website in the FAQs .

For more information about disinfecting surfaces in general, the CDC has guidelines for cleaning and disinfecting at home on their website. Remember to wash your hands frequently and thoroughly!

Thank you for your support of the bFed System. Our values include making life easier for the home tube feeder and caregiver community and putting that at the heart of everything we do.

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Bolee Bag – Not Just for Blended Diets

Tue, 17 Dec 2019 16:04:00 GMT

The Bolee Bag was introduced in February 2018 as a way to help home tube feeders more easily deliver nutrition. It was an immediate hit with the blenderized nutrition community as an easy way to both deliver and store nutrition in one container. No need to struggle with transferring your blends from the blender to a container for storage or to a syringe for delivery.

Why are Bolus Syringes a Problem?

The simple fact is that bolus syringes were designed for irrigation and flushing, not nutrition delivery. The vast majority of bolus syringes used in tube feeding are 60mL. The typical meal is over 300mL, requiring the syringe to be filled at least five times.

Now imagine filling a syringe five times at every meal – 15 times a day, 5,475 times a year – while dealing with a squirming child or an adult with dexterity issues or tremors. It doesn’t matter what type of nutrition you use, the frustration with typical syringe generated spills and messes will be overwhelming.

Why is the Bolee Bag Better?

At 375mL (13 ounces) the Bolee Bag is small enough for easy handling at meal time but big enough to hold one or more containers of nutrition from Abbott, Functional Formularies, Kate Farms, Nestle or Real Food Blends. Fill and store Bolee Bags with water so hydration is always ready and you can flush the feeding tube after every meal.

The Bolee Bag is reusable. After each use just clean with warm, soapy water, dry and refill up to 15 times over multiple days. You’ll save money and send less waste to the landfill.

The New Standard

The Bolee Bag isn’t just for special situations. All tube feeders can benefit from an easier to use tube feeding system. All tube feeders can benefit from the bFed System!

The post Bolee Bag – Not Just for Blended Diets appeared first on bFed System .

Bolus Delivery – A Meal or A Procedure?

Mon, 11 Nov 2019 21:01:00 GMT

In the Beginning there were Pumps and Syringes

Until I co-founded U Deliver Medical in 2016, all my experience in the enteral feeding business taught me that pumps were the gold standard for the delivery of tube feeding. I now realize that I was viewing tube feeding through the eyes of the clinical staff – nurses, dietitians and physicians. For them tube feeding is a clinical event, not a meal, a “procedure” that was done to someone. Formula is “medicine”, designed for specific diseases and conditions. And the reimbursement system supports this way of thinking.

It just made sense to apply technology. We designed pumps with elaborate software and alarms to make delivery of synthetic formulas safer and easier. The pump solves a clinical problem with technology. Simple things, like bolus feeding and whole food nutrition, were too simple and unsafe.

A New Perspective on Tube Feeding

The development of the bFed System has radically changed my point of view. I saw the world through the eyes of a person at home with a feeding tube or the caregiver. For them tube feeding is a meal. There’s nothing medical about it. In fact, the education delivered in the hospital, does a disservice to them. It makes them scared of something that is natural and simple.

When you consider the typical way people are introduced to tube feeding tube, it becomes even more frightening. It goes something like this. The day after being discharged with a feeding tube the DME delivery guy drops off the enteral pump and supplies. If they’re fortunate, home care agency’s nurse provides an hour’s worth of instruction. She departs and they are left on their own to cope with a pump beeps all night long at them all night long.

After much trial and error, most people figure it out. Eventually they find others in that same boat and ask questions. They get rid of the synthetic formula, dump the pump and begin living life.

That’s what I heard from caregivers as we developed the bFed System and continue to hear as I speak with customers. Tube feeding can vary from nutrition made from whole foods ( Functional Formularies and Real Food Blends ), organic, plant based ingredients ( Kate Farms ) or synthetic ingredients to home made blends. People want to prepare the meal and deliver it, but without the messy syringe! From this came the Bolee Bag , the Bolink Large Cap and Bolink Small Cap – the bFed System.

Pumps and Formula in Proper Perspective

Don’t get me wrong, pumps and formulas have a role, especially for patients in the ICU recovering from surgery or for conditions requiring a slow delivery of nutrition or specific nutrients. But, if eating by mouth is not possible and your stomach and intestines work, tube feeding is a meal that it goes through a tube – no knife, fork or spoon needed!

Now that I’m Fred, one of the Bolee Guys, I know better and I ask the question – Why Bolus when you can Bolee ?

The post Bolus Delivery – A Meal or A Procedure? appeared first on bFed System .

Blended Diet Study

Mon, 14 Oct 2019 22:06:00 GMT

Blended Diet Study for Tube-Fed Children

It’s hard to believe that the healthcare community had to conduct a special study to prove what we all know, that blended diets are good for tube-fed children! In fact, the study “Efficacy and Tolerance of Blended Diets in Children Receiving Gastrostomy Feeds” not only concluded that blended diets were well tolerated in gastrostomy ‐ fed children, but were also associated with clinical improvement of upper GI symptoms! Click here for the study abstract.

Why is it that dietitians talk to all of their patients about the benefits of fruits and vegetables, EXCEPT for their tube fed patients? Granted, it’s clinically safe to rely on the labels of synthetic formulas made of water, sugar, protein, vitamins and minerals to make sure “daily intakes” are met, BUT that is definitely not in the best interest of the long-term tube fed person.

Any recipe made from fresh fruits, vegetables and meat can be blended with other ingredients to make a complete meal for a person with a feeding tube.

But keep in mind that a registered dietitian can be a big help if you decide to start adding whole foods into your tube feeding meal time. “There are MANY variables to ensuring adequate nutrition, that is safe for your personal and medical needs. So it’s really important to start with a registered dietitian consult to assess if the regimen is appropriate for your needs,” says Danielle Penick, MS, RD, CNSC, LDN – with Survivors’ Table

Don’t have time to cook? That happens to all of us. In that instance there are manufactured tube feeding meals from Functional Formularies and Real Food Blends made from whole foods that can be a wonderful substitute for home cooking.

It’s great that clinicians are finally studying the topic (this study was supported by The Johns Hopkins School of Medicine) but the conclusions shouldn’t be a surprise to anyone.

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Updated Tips & Tricks

Mon, 07 Oct 2019 21:12:00 GMT

bFed System Tips & Tricks

The bFed System is the first innovation developed for the home tube feeding market in many years. Because the bFed System is new and different we have had a lot of great feedback from customers sharing their tips & tricks for using the system. Here are some of the most useful tips & tricks so far.

Burp the Bolee Bag

Extra air in the Bolee Bag can make it difficult to squeeze and prevents good nutrition flow through the tubing. To remove the air (burp) simply fill your Bolee Bag with your nutrition, attach the Bolink Large Cap, keep the Bolee Bag facing up so the extra air is by the cap and before attaching to the extension set or feeding tube, squeeze the Bolee Bag until the air is gone and the Bolink tubing is filled with your nutrition.

If you are using a packaged tube feeding formula from a manufacturer like Abbott, Kate Farms or Nestle, gravity alone may be enough to create a steady flow. In this case you don’t need to burp the Bolee Bag. Leaving a little air in the top of the bag provides the pressure needed to empty it and clear the Bolink tubing.

Roll the Bolee Bag and Squeeze

If your nutrition is thick and you need to squeeze the Bolee Bag to create flow, roll the Bolee Bag so the empty space is reduced and pressure is focused solely on pushing the nutrition through the tubing. Provide consistent, steady pressure to the pouch to create flow. Squeezing extremely hard will not improve the flow rate.

Use a Bolus Extension Set

If you have a low profile feeding tube make sure you use a bolus extension set rather than a pump extension set. The bolus extension sets have larger tubing and goes straight into the feeding tube.

Food Left in the Cap?

When you are at the end and no more nutrition is coming out but you know there is still nutrition left in the cap, ever so slightly loosen the Bolink Large Cap to release the vacuum allowing the last little bit of nutrition to flow. Don’t loosen the Bolink Large Cap too much otherwise the nutrition will leak all over the place.

Still Hard to Squeeze the Bolee Bag?

Have you tried all of the above tips & tricks and it’s still hard to get the nutrition flowing? This issue usually comes up when home made nutrition or prepackaged blenderized nutrition is used. The problem is usually resolved by blending the nutrition longer (at least 3 minutes) and/or thinning out the nutrition with water, broth, coconut milk or some other type of fluid.

The amount of water needed to dilute will vary based on your nutrition, but we have found that as little as 2-3 ounces of fluid is enough to increase the flow substantially. In some cases it eliminated the need to squeeze.

Bolink Small Cap

The Bolink Small Cap connects to a variety of puree pouches (not Gerber) found at your local grocery store. The brands we have confirmed are: Plum Organics, Earth’s Best, Wild Harvest, Happy Baby, Happy Tot, Beechnut and Abbott Go & Grow. Fruit and vegetable only purees flow best. Products with oatmeal or meat tend to be really thick and can clog the tubing.

For reusable pouches we have confirmed that Baby Brezza and Rhoost provide secure connections.

Again, make sure to use the bolus extension set if you have a low profile feeding tube. Provide consistent, steady pressure to the pouch to create flow. Squeezing extremely hard will not improve the flow rate and could cause the pouch to burst. It can take up to 5 minutes to empty the pouch depending on the thickness of the puree.

Is There an Easier Way to Fill the Bolee Bag

Click here to learn more and order.

Is There a Way to Hang the Bolee Bag?

It took a while but we found a durable multi-function clip for the Bolee Bag that allows you to hang it for easier gravity tube feeding nutrition delivery. This heavy duty versatile clip swivels and has both a hook and a hole so you can hang your Bolee Bag wherever you go.

Click here to learn more and order.

Thank You!

Thank you to everyone who has sent in their tips & tricks. If you have a tip or trick you want to share please send it to info@udelivermedical.com or post it on our Facebook page – BFedSystem

The post Updated Tips & Tricks appeared first on bFed System .

Emergency Kit

Tue, 16 Jul 2019 21:54:00 GMT

You Never Know

With our headquarters in Minnesota, we’re familiar with bad weather. Blizzards, tornadoes, hail and thunderstorms can cause major disruptions in electrical power and isolate you even if you live in a metro area like the Twin Cities. If it’s bad you go to the basement, wait out the storm. If it’s really bad like a hurricane on the coasts, you have to evacuate. You learn quickly that you should always have a emergency preparedness kit ready with canned or freeze dried food and water.

If you have feeding tube it’s a different story. No power means that when your pump battery looses its charge, it dies. Without refrigeration you have to manage your nutrition carefully. Tube feeding isn’t easy but under these circumstances it becomes especially hard.

That’s why we created the bFed System Tube Feeding Emergency Kit . The bFed System is perfect for emergencies. You don’t need power, just gravity. The emergency kit contains:

You can connect the Bolink Small Cap directly to pureed food pouches or fill the Bolee Bag, attach the Bolink Large Cap, connect to your feeding tube and you’re good to go.

Order one or more today and keep them with your other emergency supplies. Click here to learn more.

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No Prescription Needed

Wed, 05 Jun 2019 13:42:00 GMT

The First Tube Feeding Delivery System Available Without a Prescription

Launched in February 2018, The bFed System is an innovative tube feeding delivery system that makes it easier for home tube feeders to deliver any form of nutrition they choose. “Home tube feeders and their caregivers face enough obstacles in daily life without having additional restrictions when choosing options for getting the nutrition they need,” said Brian Johnson, president and co-founder of U Deliver Medical. “Requiring a prescription was an additional burden resulting in more contacts with healthcare providers for a person that already has a feeding tube and can’t eat by mouth,” added Fred Reuning, vice-president and co-founder of U Deliver Medical. “We created The bFed System specifically to help make tube feeding a little easier, so we are extremely pleased that it is now more readily available.”

Vista Regulatory Solutions, LLC ( www.vistareg.com ) led the development of the regulatory strategy and managed the submission process with the FDA. “It was a pleasure to work with U Deliver Medical in developing their regulatory strategy for the Bolink products. These products were a natural fit for over-the-counter use as was evident by the usability testing that showed they could be used safely without direction from a health care professional,” said Tom Dold, president, Vista Regulatory Solutions.

About U Deliver Medical
Founded in 2016, U Deliver Medical LLC is dedicated to providing home tube feeders with nutrition delivery products that give them the freedom to choose how to deliver the nutrition they need when they want it and where they want it. Nutrition is vital to improved health and healing, and tube feeding delivery needs to evolve to eliminate barriers for proper nutrition to be achieved.

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Tube Feeding Support Resources

Wed, 03 Apr 2019 18:40:00 GMT

Who Can Help Me?

One thing that is apparent to everyone involved in tube feeding is that finding tube feeding support resources is hard, especially when you are struggling and need it most. Starting tube feeding is usually secondary to a primary diagnosis – cancer, disease, mental aversions, or something else. The majority of care discussions focus on that condition leaving tube feeding as an afterthought.

How about that, eating, the fuel supporting the healing of your body, is an afterthought! Doctors and nurses, the main point of contact for most people, get very little nutrition education during their training. Dietitians, a great resource, are spread way too thin in most clinics. So, most caregivers turn to the internet for tube feeding support resources. Great, more work sifting through information to determine what to do.

Where Can I Find Help?

One of the best things about Facebook are the groups dedicated to specific causes. Luckily, that includes tube feeding and there are a number you can to turn to. Typically, they are closed and you’ll have to apply for membership. Very often the group moderator either has a feeding tube or takes care of a tube fed person. These extra steps along with active moderation help make sure the content stays on topic and is relevant.

In these groups you’ll be a member of a supportive community. When you ask a question, the responses comes from someone in your situation. Here are a few to check out:

Facebook/FeedingTubeAwareness

Facebook/Adulttubefeeding/

Facebook/realfoodfortubefedkids/

Facebook/nutritionalfoodblendsfortubies/

Facebook/BlenderizedRN/

In addition to Facebook pages the organizations dedicated to tube feeding have websites with great information. You can check out their Facebook page to create dialogue, but the website provides a deeper level of tube feeding support resources.

Oley.org

Feedingtubeawareness.org

You Are Not Alone

In the United States an estimated 500,000 people are living with a feeding tube. No matter how overwhelmed and alone you may feel, rest assured that someone out there has had the same experience. Be aware that there is also a lot of misinformation out there so be sure to as pointed questions of your care team before making changes.

Explore the resources listed above and don’t be afraid to ask questions.

The post Tube Feeding Support Resources appeared first on bFed System .

Flow Rates

Fri, 22 Feb 2019 18:03:00 GMT

The bFed System is flexible! Patients and caregivers can use it as a gravity tube feeding system by letting the nutrition flow naturally or a bolus tube feeding system by squeezing the Bolee Bag to create the delivery speed needed. Below are gravity delivery speed times for a variety of undiluted commercial formulas using the bFed System and a straight bolus extension set:

When using the bFed system, keep in mind that thickness and temperature of the nutrition being delivered affects the gravity delivery speed and the ease of squeezing the Bolee Bag.

Functional Formularies (Liquid Hope & Nourish), Real Food Blends, Compleat Organic Blends and homemade blenderized nutrition also work well with the bFed System. Due to their variable thickness, squeezing (bolus tube feeding) is required to deliver the nutrition. It also helps to add additional liquid to the blend to make it flow easier.

Squeezing pressure will vary by individual so we did not time test the delivery of these products.

Over the last thirty years the gravity and bolus home tube feeder has had virtually no new options for nutrition delivery. We developed the bFed System to make home tube feeding nutrition delivery a little bit easier and a whole lot more flexible.

In the car? At the park? At work? At school? At home? The bFed System goes with you wherever you are.

Use commercial nutrition or make your own? The bFed System has the flexibility to meet your needs. Click here to learn more about the products.

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Medicare & DME Suppliers

Fri, 18 Jan 2019 22:16:00 GMT

Competitive Bidding

On January 1, 2019 there was a major change in the Medicare landscape that opened the tube feeding supply market to any Medicare enrolled durable medical equipment (DME) provider. Prior to January 1, 2019 the tube feeding supply market for Medicare beneficiaries was limited to DME providers that contracted with the government to provide tube feeding nutrition and delivery supplies at the lowest price based on a CMS program called “Competitive Bidding”. If the DME did not have a contract they could not provide the service.

As of January 1, 2019 that program called “Competitive Bidding” was put on hold until December 31, 2020 and all contracts with DME suppliers have been allowed to expire.

During this time gap the home tube feeding patient that is on Medicare can choose to work with any Medicare enrolled DME provider and the Centers for Medicare and Medicaid Services (CMS) will work with stakeholders to better define a payment system that works for everyone involved.

What Does This Mean?

This change means the home tube feeder that is on Medicare should have a larger number of DME suppliers to choose from when it comes to getting their tube feeding nutrition and supplies. It also means that a current DME supplier may choose to no longer provide tube feeding nutrition and supplies since their contract with CMS has expired.

CMS has provided the following information for those that are looking for a new DME supplier:

Use the Medicare Supplier Directory ( www.medicare.gov/supplier ) to locate a
supplier.

• Call 1-800-MEDICARE (1-800-633-4227) to locate a supplier, ask a question, or
file a complaint.

• Ask if the supplier accepts Medicare assignment. If the supplier doesn’t accept assignment, the person with Medicare could be responsible for paying higher coinsurance.

• Beware of aggressive marketing by suppliers:

–Don’t let anyone persuade you to switch suppliers. Talk to your supplier
first because you may not need to make a change.

–Remember that Medicare and Medicaid don’t send representatives to
homes to sell products or services.

–Don’t be influenced by certain media advertising. Many television and
radio ads don’t have your best interest at heart.

–Report fraud using the HHS Office of Inspector General’s
“ https://forms.oig.hhs.gov/hotlineoperations/report-fraud-form.aspx ”
online form, or call the Fraud Hotline of the HHS Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477).

Requesting the bFed System

This suspension of “Competitive Bidding” makes it easier to get your DME to supply you with the bFed System. Sometimes DMEs resist bringing in new products, like the Bolee Bag and Bolink Large Cap for patients. U Deliver Medical will work with you to help make that happen, but if that is not possible this change gives you the power to switch to a DME which will provide the bFed System. Let us know how we can help!

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Tips & Tricks

Thu, 01 Nov 2018 19:54:00 GMT

bFed System Tips & Tricks

Burp the Bolee Bag

Roll the Bolee Bag and Squeeze

Use a Bolus Extension Set

If you have a low profile feeding tube make sure you use a bolus extension set rather than a pump extension set. The bolus extension sets have larger tubing and goes straight into the feeding tube.

Food Left in the Cap?

Still Hard to Squeeze the Bolee Bag?

Bolink Small Cap

For reusable pouches we have confirmed that Baby Brezza and Rhoost provide secure connections.

Thank You!

Thank you to everyone who has sent in their tips & tricks. If you have a tip or trick you want to share please send it to info@udelivermedical.com or post it on our Facebook page – BFedSystem

The post Tips & Tricks appeared first on bFed System .

Learning More About Blenderized Tube Feeding

Thu, 11 Oct 2018 19:09:00 GMT

At the recent Wisconsin Society for Parenteral and Enteral Nutrition (WISPEN) fall symposium, Lisa Epp, RDN, LD, CNSC gave a great presentation on blenderized tube feeding (BTF) practices. Lisa is a national expert on BTF an Assistant Professor of Nutrition at the Mayo Clinic and the home enteral nutrition coordinator for Mayo Clinic’s Home Enteral Nutrition Program. Under her leadership they have embraced BTF in their practice. She did a fantastic job of passing on their expertise in the presentation and breakout sessions.

There’s a lot of Blending going on!

Based on numerous studies and reports, using commercial and homemade BTF is getting more common. In one large 1,519 person online survey done in 2015, 23.6% of pediatric ( under age 18) respondents and 14.9% of adult respondents used BTF for some, if not all of their nutrition. Many people used a combination of commercial formulas and BTF.

The respondent’s primary reasons for using BTF are that it is more natural, makes me feel more “normal”. Most felt physically better and had less reflux or vomiting with more regular bowel movements.

Of the people that didn’t use BTF, the reasons given were it is a major time commitment, they didn’t know it was possible or had no support from their provider to start blending.

Putting BTF into Practice – Best Practices

-Blender type and time matter. High end blenders like Vitamix and Blendtec require less blending time and will last longer. Less powerful blenders require longer blending time and can quickly wear out.

-Hang time (time un-refrigerated) for homemade BTF is 2 hours.

-Syringes are difficult to use but O-ring syringes work better than ones with gasket syringes, which tend to get sticky and difficult to use quickly.

-Pumps don’t handle BTF well and most pump manufacturers advise against it.

-Gravity sets must have large diameter tubing to handle BTF.

-ENFit® connectors require extra care to keep the feeding tube port free of residue. The best ways to do that is to keep the syringe tip clean and make as few connections and disconnection as possible.

-BTF can clog feeding tubes so check the tube to make sure it is still working. Interestingly, many blenders report clogs but find it easier to get rid of the clog than clogs from commercial tube feeding formulas.

Creating a BTF Nutrition Plan

Lisa had a number simple recommendations to consider when putting together a tube feeding plan with btf.

-Keep it simple.

– There are a lot of online resources available but work with a dietitian to develop a food plan and standard recipes.

– Use “ My Plate ” template to convert family meals to balanced, healthy BTF.

-It is OK to use commercial formulas as a base to develop your BTF recipes and ensure that nutritional needs are met.

-Use new commercial whole food tube feeding products ( Functional Formularies , Real Food Blends ) when convenience is needed or to give yourself a break from the work.

-Multi vitamins aren’t always necessary so consult with a dietitian to be find out if you really need one.

-Monitor weight and make corrections for any weight loss or gain. Studies and experience have found that sometimes it takes more calories to maintain weight with BTF, possibly because of the energy expended to digest BTF.

A Dietitian’s Perspective

To sum up, the biggest take away from the session is that Lisa urged the dietitians at WISPEN to be open to BTF, especially when a patient asks about it. It is important for patients to see their dietitian as a supportive partner. In her practice she uses patient questions about BTF as an opportunity to learn from patients, educate them on good nutrition and encourage active involvement in nutrition planning. She works with her patients to learn about the very creative ways they have developed to deliver the new nutrition, whether it is a homemade blend a new commercial whole food tube feeding.

How Does the bFed System fit into this new landscape?

The Mayo Clinic (and many other clinics and home care suppliers) see the benefits of the bFed System. It has Bolee Bags, Bolink Large Cap and Small Cap as a recommended delivery systems in its home enteral nutrition orders.

Make sure to ask your care team and home care supplier for the bFed System!

Click here to see the latest list of home care suppliers supporting the bFed System.

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A Picture Is Worth…

Tue, 17 Jul 2018 17:48:00 GMT

We have a lot of information on our website but, as the saying goes, a picture is worth a thousand words. In this instance it is videos instead of pictures but you get the point.

We have created a YouTube Channel that has all sorts of videos showing the bFed System in action. Click b Fed System YouTube Channel to see our videos and don’t forget to subscribe so you get an alert when we add more.

Do you have a video of the bFed System in use? We would love to see it – send it to info@udelivermedical.com.

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Is Your Time Valuable?

Thu, 28 Jun 2018 18:39:00 GMT

Time to Eat

Is your time valuable? Of course it is! If you’re a caregiver for someone with a feeding tube or you have a feeding tube yourself, your time is even more valuable.

Leisurely meals are a thing of the past if you have a feeding tube. Gathering up your delivery supplies, blending your nutrition or opening containers of pre-made nutrition all take time and pre-planning. What if you go to school or work? Being on the go adds even more layers of complexity to mealtime.

If you bolus feed you have the added complexity of filling and delivering SIX syringes…ugh…who wants to do that? What are your options? Switch to an enteral feeding pump? That will bring in a whole new batch of challenges.

This is precisely the reason the bFed System was created. Time is too precious of a commodity to spend gathering equipment and filling and delivering six bolus syringes at every meal – 18 per day!

10 Ways to Save Time With The bFed System

1. Fill multiple Bolee Bags with your favorite nutrition (commercial or blenderized) and store them in your refrigerator. At mealtime all you have to do is grab a Bolee Bag and connect to have your meal.

2. Prepare and fill a weeks worth of blenderized nutrition in Bolee Bags and store them in your freezer. Each night take out what you need for the next day and thaw in the refrigerator.

3. Fill multiple Bolee Bags with water and store them in your refrigerator. You will always have hydration on hand when you need it.

5. Fill and deliver one Bolee Bag, rather than six syringes, at each meal – significantly faster with less mess.

6. Bolee Bag is both your storage container and delivery mechanism, less equipment means quicker meals.

7. The five inch Bolink tubing primes significantly faster than the 70 inch gravity sets, meaning you don’t have to wait as long to begin your meal.

8. Simply squeeze the Bolee Bag to control how fast the fluid flows.

9. Caught out of the house without your tube feeding food? Don’t go all the way home – stop at the closest grocery or convenience store to buy a puree food pouch and connect with the the Bolink Small Cap (we recommend keeping a Bolink Small Cap in every glove compartment).

10. Save time cleaning – no exploding syringes or messes to clean up!

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Summer Fun & Tube Feeding

Wed, 23 May 2018 16:53:00 GMT

On The Road

Memorial Day is fast approaching, and that means lots of outdoor activities. Whether it is to spend time with family, watch sports, play sports or just enjoy nature, being outside in the summer helps most of us forget about the long winter we’ve just been through.

A 2016 survey from the National Recreation and Park Association asked 1,000 American adults about their favorite summertime outdoor activities.

The top five favorite summertime activities are:

Outdoor Fun & Tube Feeding

While we all love being outside on a beautiful summer day, being outside while also caring for a person with a feeding tube adds another layer of planning. Having the right tools can go a long ways in making sure everyone has a good time.

Food

Even if you’re not having a picnic, you will want to bring some food and water with you so you don’t have to stop your good time to go in search of something to eat or drink.

For a person with a feeding tube, make sure you pack plenty of whatever nutrition you normally use – pre-packaged commercial nutrition or your favorite homemade blend (if you are on a blenderized diet) and water.

Typically you would use a bolus syringe to deliver your nutrition, but being outside offers up the possibility of contaminants getting in your food. Luckily, there is a new bolus delivery system to make it easier for people with a feeding tube to eat outside.

You can also fill multiple Bolee Bags with water, so staying hydrated will never be an issue. The Same Bolink Large Cap can be used with with all the Bolee Bags you pack, saving you space in your car or bag.

Have Fun!

Now that the bFed System has solved all of your outdoor tube feeding delivery issues, you can focus on having fun and enjoying the summer sun! Learn even more by clicking here .

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Making Blenderized Tube Feeding that Flows

Fri, 04 May 2018 14:01:00 GMT

Taking Control

Over the last 5 years, more and more people have made the decision to make their own blenderized tube feeding nutrition using fresh vegetables, fruits, whole grains and protein. Why not tube feed what you would normally eat without a feeding tube? For most people, it is a trial and error process to develop recipes that work for them nutritionally, and then to figure out how to blend them so that they actually flow through their feeding tube.

Consistency is Critical

Creating the proper consistency is really an “art” that takes time to figure out. Is it the amount of liquid or length of time blending that gives you the right consistency – or both? For most people, finding that right consistency is all about constant tweaking and knowing it when you see it. Without the proper consistency you blend will not be able to flow using an enteral pump or it could be very difficult to deliver by bolus or gravity.

Based on some recent work by done by the Mayo Clinic and a research group at the Food and Drug Administration (FDA), here are some basic things to keep in mind as you blend for your tubie.

Thickness matters. The thinner the blend, the easier it is to deliver it.

“Chunks” matter. The smoother the blend, the less likely it is to clog your tube.

Blenders matter. The better the blender, the easier it is to create a blend that flows smoothly.

Blender time matters. The longer the blending time, the better the blend.

Fluid in the blend matters. Fluid (water or broth) content determines the thickness or thinness of the blend but can also dilute the nutritional value of your recipe – don’t overlook this key aspect.

Before we talk about the processing of the blend, it is important to emphasize nutritional content. The nutritional content should be first and foremost in your blend. You must have the right mix of fat, carbohydrates and protein as well as fluid to maintain your health.

There are many online resources with great information, but to ensure that your blend is nutritionally complete you should work with a qualified nutritionist who understands your circumstances. A registered dietitian who supports homemade tube feeding nutrition can be your best friend.

Key Parts of the Blending Process

The blender: The range of blenders available goes from low power/low cost products, like an Oster Blender which you can find in most every kitchen, to a mid-range product with more power at slightly higher price, like a Ninja, to a high power, industrial strength/high cost product like a Vitamix or Blendtec. Get a Blendtec or Vitamix if you can afford it. The time spent blending will be much more efficient using a high speed/high power blender. Both companies offer medical assistance so check out their websites for more details.

Blending time: Most people blend from 1 to 3 minutes. Typically, the longer the blend the finer the particles in the blend. Fine particles mean less clogging and better flow rates. Blending more than 3 minutes doesn’t make much of a difference.

Fluid or water content: Fluid or water is very important for health, and is something to discuss with your healthcare provider. It determines the thinness or thickness of the blend. But it is also critical for the processing the ingredients, because it impacts the efficiency of your blender. The right amount of water allows the blender to chop and pulverize the ingredients effectively. If there is too little fluid in the blend, the ingredients won’t turn over in the container, meaning that the blades won’t chop them up as fine as possible. If calories are a concern you can use a liquid other than water to add extra calories as well as vitamins and minerals.

Storage

After you make your blend you can store it in a variety of containers, but the Bolee Bag from the bFed System was specifically designed for this purpose. The Bolee Bag holds almost 13 ounces of liquid, which should be enough for a meal. When it comes time to eat, attach the Bole Bag to your feeding tube or extension set (a straight bolus extension set is best) with the Bolink Large Cap, sit back, and squeeze to create the flow you want.

Give it a try

It’s not an easy decision to make your own blenderized tube feeding nutrition and it should be discussed with your healthcare team first, but most people will agree that it is the best decision for long-term tube feeders.

If you decide to blend your own, do your research first (there are a lot of resources on Facebook and Pinterest) and be prepared to make mistakes – it’s okay.

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What is ENFit?

Tue, 24 Apr 2018 21:13:00 GMT

Background

Medical product connections have long been a concern in hospitals. Picture yourself as a nurse in a darkened patient room, or a parent taking care of a complex child at home. One of the machines connected to the patient alarms. You’re tired because it’s the middle of the night and it’s the fifth time something’s alarmed, but you have to check the equipment to stop the alarm. You keep the lights low to keep from waking the patient, making it difficult to see. You start to adjust connections of the multiple tubes attached to the patient and the equipment until you find the one that shuts off the alarm.

You’re positive that you have reconnected everything correctly and leave. If you’re the nurse, you move on to the next patient. If you’re the parent, you collapse in a chair thankful for a moment of rest. Ten minutes later a new alarm goes off. You check on it only to find out that you made a mistake. The connections you made were wrong, and the patient got sicker…or worse yet, died.

Sound far fetched? It happens more often than you think.

A Little History

Since the early 2000s, doctors, nurses and patients have called attention to the threat of misconnections. This patient safety concern rose to new heights when California passed a law in 2012 that required dedicated enteral connectors (ENFit) be used in health facilities (hospitals, nursing homes, or patient care centers) by July 1, 2016. If a health facility does not use enteral specific connectors they will be charged with a misdemeanor. The catch was that facilities could not use enteral specific connectors if they did not exist. That issue pushed the enteral industry manufacturers to create a new connector design that was a standard, rather than everyone creating their own design.

The enteral nutrition industry, comprised of nutrition manufacturers, medical device manufacturers, component suppliers and distributors, came together with clinicians, caregivers and the Food and Drug Administration (FDA) to design a dedicated enteral connector that minimized misconnections without greatly reducing the flow of nutrition.

The International Standards Organization (ISO) also got involved to make sure the new design standard, 80369-3,that was developed and was approved through a world-wide process. This lead to the creation of the ENFit connector. Even though ENFit is a global standard, it is unlikely that it would have been created if California had not passed that law.

In addition to enteral nutrition connectors, new standards were created for connectors in these systems:

Respiratory products

Urology products

Blood pressure cuffs

Neuraxial devices including epidural and regional anesthesia devices

I.V. catheters and hypodermic needles that use existing Luer connectors

By the time all of the related products have new connectors in place, it will be very difficult for a misconnection to occur. It won’t be 100% foolproof, as there are some products without specific connector design standards (like tracheostomy tubes), but the chances of a misconnection are greatly reduced.

Now everyone is asking the same question: I know misconnections can happen, but if I live at home with a feeding tube and take care of it myself, why do I have to switch? Great question. You don’t have to as long as your doctor and the medical supply companies you work with are willing to supply the existing funnel style feeding tube and the manufacturer continues to make it. At the time of writing this post, manufacturers continue to make feeding tubes with funnels, and an adapter exists to make an ENFit tube feeding administration set or syringe work with a funnel extension set or feeding tube.

Keep in mind though that if you have a feeding tube without ENFit and end up in a hospital, your risk for harm due to a misconnection increases. Plus, if the hospital has converted to ENFit, there could be a delay in feeding you because they no longer use the old system.

Why are Some Home Tube Feeders Unhappy With ENFit?

The first reason is change. No one likes to be forced to change, especially when you have been doing something one way for a long time. Communication around the implementation of ENFit products and the lack of clarity on timing has created a lot of confusion.

One month you get your normal supply of tube feeding delivery products, and then the next month all of your products have switched to ENFit. Who wouldn’t be confused by that?

Another reason for complaints is that the ENFit opening is slightly smaller than the original stepped connector (also called a Christmas tree).

The ENFit connector is slightly smaller than the stepped connector, but if you use commercial nutrition or blend your own nutrition to a thin consistency, you shouldn’t have any flow issues.

If you use a low profile button feeding tube, the ENFit connector is larger than the connection to your low profile feeding tube.

Is There A Silver Lining?

For all of you bolus tube feeders, how many times have you pushed the plunger too hard and had your food go all over the floor, walls, ceiling or worse yet – a friend?

For all of you overnight pump tube feeders, how many times have you woken up to find the set disconnected from the tube and a bed full of tube feeding nutrition (also known as feeding the bed)?

The silver lining of ENFit is that it has a screw connection, so accidental disconnections and the messes they create are less likely to happen. All of the bFed System products have the ENFit connector. Learn more here

In the long run, lowering the risk of misconnection is everyone’s goal. Whether it is accomplished through ENFit or some other dedicated design, tube feeding will be safer for patients and caregivers everywhere.

Here are some more resources if you want to learn more:

ECRI Article

Oley.org

feedingtubeawareness.org

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Tube Feeding Delivery Options

Mon, 02 Apr 2018 15:21:00 GMT

Top 3 Things To Consider When Choosing A Tube Feeding Delivery Method

When you or someone you care about is diagnosed with a health issue that requires a feeding tube, the most commonly recommended delivery system is a 60mL plastic syringe that wasn’t designed for tube feeding. Most people will settle for this delivery method and find tips and tricks to make it work for them. WHY?

Here are three things to consider when deciding on a tube feeding delivery method:

Real Food or Synthetic Tube Feeding Formula?

Synthetic formulas are the go-to recommendation of most doctors and dietitians, because that’s what they were trained to recommend. The products are considered nutritionally complete when it comes to recommended vitamins and minerals, and they meet food safety requirements and have been formulated for specific conditions. The delivery systems are designed to work with them.

Many people are finding that synthetic formulas just don’t cut it. Sure, they are convenient and flow through tubing easily (due to their thin design), but they get their calories from loads of sugar and other processed ingredients.

Yes, they have the recommended vitamins and minerals, but they are synthetic. This means our bodies absorb them differently from the vitamins and minerals we get from real food.

In response, a growing group of tube feeders and their caregivers have started to blend their own food. It takes some time to do it, but the people who have the time to blend their own tube feeding nutrition have found it the best option for their long term health.

There are a lot of great resources on the internet with recipes for blending your own food, plus support groups on Facebook to help and support you as you learn to do so. Why should a person using a feeding tube not eat real food?

In the last few years a number of new companies have come out with mass produced tube feeding formulas made from real food. This is a great convenience for the home tube feeder; they can get the benefits of real food without having to make and store their own blends.

Stationary or on the Move?

You want to make sure your delivery system matches your lifestyle. If you are active – going to school, work, travel – you don’t want your movement limited by how you eat your meals.

Pumps and gravity systems take time and have special set up instructions. Because of that, many people get frustrated. They don’t want to hang a bag full of food and sit and wait for the bag to drain.

If they’re using a syringe to deliver their food, it takes time bolus syringes and it can get messy, especially when they leak or accidentally disconnect.

Daytime or Night-time Tube Feeding?

If you decide to tube feed overnight, an enteral tube feeding pump is a great choice. Enteral tube feeding pumps can be programmed to deliver small amounts of food over a long period of time and will alarm to wake you up if there is an issue.

But, if you want to tube feed blenderized real food, you may want to reconsider. The pumps aren’t designed to deliver thick, chunky nutrition. In fact, some pump manufacturers specifically warn against blenderized real food delivery.

If you are strictly going to tube feed during the day and don’t have any volume restrictions, you probably don’t want to be tied to an enteral feeding pump and will choose between bolus or gravity feeding systems.

In the end, you have options to choose the tube feeding delivery system that is right for you. A little self evaluation of your lifestyle will help you make the right choice.

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